Takasago, Tomoya Tokushima University
Hamada, Daisuke Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Wada, Keizo Tokushima University Tokushima University Educator and Researcher Directory
Nitta, Akihiro Tokushima University
Tamaki, Yasuaki Tokushima University Tokushima University Educator and Researcher Directory
Goto, Tomohiro Tokushima University KAKEN Search Researchers
Tsuruo, Yoshihiro Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Sairyo, Koichi Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
bicruciate-retaining total knee arthroplasty
anterior cruciate ligament
computer navigation system
biomechanical cadaveric study
Thesis or Dissertation
Background: Soft tissue balancing in bicruciate-retaining (BCR) total knee arthroplasty (TKA) is a challenge that must be overcome to achieve excellent clinical outcomes. However, the optimal degree of joint laxity has yet to be clarified. This cadaveric study sought to examine joint laxity after BCR TKA using a navigation system.
Methods: Knee joint laxity was quantified using an image-free navigation system in 8 intact fresh frozen cadavers under three conditions: the native knee, BCR TKA knee, and BCR TKA knee after anterior cruciate ligament resection. Rotational kinematics in the BCR TKA knee during flexion were compared according to whether joint laxity was increased or decreased.
Results: Knee joint laxity after BCR TKA under varus-valgus movement, anterior translation, and internal-external rotation loadings was similar to that of the native knee. However, lateral joint laxity was decreased during flexion in some cases. BCR TKA-treated knees with decreased lateral joint laxity at 90° of flexion demonstrated more limited tibial internal rotation in deep flexion than the native knee (p < 0.05). The loss of internal rotation in deep flexion was partly recovered by using a lateral insert with a posterior slope of +3°.
Conclusions: Restoring optimal joint laxity was not always straightforward in BCR TKA if the 4 ligaments were preserved. Lateral joint laxity was potentially decreased in BCR TKA and may result in kinematic conflict during flexion. Surgeons should be aware of the need to achieve sufficient lateral joint laxity in this type of BCR TKA.
© 2021 Elsevier B.V. All rights reserved.
|DOI (Published Version)|
|URL ( Publisher's Version )|
k3536_abstract_review.pdf 220 KB
k3536_fulltext.pdf 437 KB
|MEXT report number||
Doctor of Medical Science