J Knee Surg 2021; 34(09): 1014-1025
DOI: 10.1055/s-0040-1701265
Original Article

Can Computer-Assisted Total Knee Arthroplasty Support the Prediction of Postoperative Three-Dimensional Kinematics of the Tibiofemoral and Patellofemoral Joints at the Replaced Knee?

1   Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
,
Silvia Tamarri
1   Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
,
Andrea Ensini
2   1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
,
Stefano Durante
3   Nursing, Technical and Rehabilitation Assistance Service, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
,
Maurizio Ortolani
1   Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
,
Alberto Leardini
1   Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
› Institutsangaben

Funding The study was funded by the Italian Ministry of Economy and Finance, program “5 per mille.”.
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Abstract

The aim of this study was to analyze the extent to which postoperative patellofemoral joint (PFJ) kinematics assessed at 6-month follow-up after total knee arthroplasty (TKA) mimics the intraoperative kinematics after final component implantation. The study hypothesis, already proved in terms of tibiofemoral joint (TFJ) kinematics, is that the intraoperative assessment of PFJ kinematics after component implantation is also capable of predicting postoperative knee kinematics during activities of daily living. Twenty patients selected for TKA with patellar resurfacing were implanted using surgical navigation, including patellar component positioning via a novel computer-assisted procedure. This allowed for intraoperative TFJ and PFJ kinematic assessment after final component implantation. At 6-month follow-up, all patients were contacted for follow-up control; in addition to clinical examination, this implied postoperative kinematics assessments by three-dimensional video fluoroscopy of the replaced knee during standard activities of daily living. Several traditional PFJ, as well as TFJ, rotations and translations were calculated intra- and postoperatively and then statistically compared. Good postoperative replication of the intraoperative measurements was observed for most of PFJ variables analyzed, as well as those for TFJ. Relevant statistical analysis also supported the significant consistency between the intra- and postoperative measurements. Pertaining to the present findings on a statistical basis, intraoperative measurements performed at both TFJ and PFJ kinematics using a surgical navigation system under passive conditions, are predictive of the overall knee kinematics experienced at postoperative follow-ups by the same replaced knees in typical activities of daily living.

Ethical Approval

The study was approved by the ethical committee of the Istituto Ortopedico Rizzoli, Bologna, Italy (Prot. Gen 0039521, November 16 2012). The authors certify that the institution approved the investigation protocol that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. Relevant study details are also reported in the clinicaltrials.gov repository with identification number NCT03448198.


Authors’ Contributions

C.B., A.E., and A.L. contributed to study design; C.B., S.T., S.D., and A.E. contributed in the technical development of the adopted instrumentation; A.E. was involved in patient selection, and in pre- and postclinical evaluations; C.B., S.T., M.O., and A.E. contributed to data acquisition; C.B., S.T., M.O. and A.L. contributed in technical/morphological data analysis and interpretation; C.B., S. D., and A.E. were involved in clinical and radiological data analysis and interpretation. All authors were involved in combined data interpretation, in manuscript drafting and in the critical revision of this manuscript. All authors have read and approved the final submitted manuscript.




Publikationsverlauf

Eingereicht: 09. Mai 2019

Angenommen: 13. Dezember 2019

Artikel online veröffentlicht:
19. Februar 2020

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