論文

査読有り 国際誌
2020年5月

Excessive flexed position of the femoral component was associated with poor new Knee Society Score after total knee arthroplasty with the Bi-Surface knee prosthesis

Bone and Joint Journal
  • K. Nishitani
  • ,
  • S. Kuriyama
  • ,
  • S. Nakamura
  • ,
  • N. Umatani
  • ,
  • H. Ito
  • ,
  • S. Matsuda

102
6
開始ページ
36
終了ページ
42
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1302/0301-620X.102B6.BJJ-2019-1531.R1

© 2020 British Editorial Society of Bone and Joint Surgery. All rights reserved. Aims This study aimed to evaluate the association between the sagittal alignment of the femoral component in total knee arthroplasty (TKA) and new Knee Society Score (2011KSS), under the hypothesis that outliers such as the excessive extended or flexed femoral component were related to worse clinical outcomes. Methods A group of 156 knees (134 F:22 M) in 133 patients with a mean age 75.8 years (SD 6.4) who underwent TKA with the cruciate-substituting Bi-Surface Knee prosthesis were retrospectively enrolled. On lateral radiographs, γ angle (the angle between the distal femoral axis and the line perpendicular to the distal rear surface of the femoral component) was measured, and the patients were divided into four groups according to the γ angle. The 2011KSSs among groups were compared using the Kruskal-Wallis test. A secondary regression analysis was used to investigate the association between the 2011KSS and γ angle. Results According to the mean and SD of γ angle (γ, 4.0 SD 3.0°), four groups (Extended or minor flexed group, ''0.5° ≤ γ < 2.5° (n = 54)), Mild flexed group (2.5° ≤ γ < 5.5° (n = 63)), Moderate flexed group (5.5° ≤ γ < 8.5° (n = 26)), and Excessive flexed group (8.5° ≤ γ (n = 13)) were defined. The Excessive flexed group showed worse 2011KSSs in all subdomains (Symptoms, Satisfaction, Expectations, and Functional activities) than the Mild flexed group. Secondary regression showed a convex upward function, and the scores were highest at γ = 3.0°, 4.0°, and 3.0° in Satisfaction, Expectations, and Functional activities, respectively. Conclusion The groups with a sagittal alignment of the femoral component > 8.5° showed inferior clinical outcomes in 2011KSSs. Secondary regression analyses showed that mild flexion of the femoral component was associated with the highest score. When implanting the Bi-Surface Knee prosthesis surgeons should pay careful attention to avoiding flexing the femoral component extensively during TKA. Our findings may be applicable to other implant designs.

リンク情報
DOI
https://doi.org/10.1302/0301-620X.102B6.BJJ-2019-1531.R1
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32475263
Scopus
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85085854291&origin=inward
Scopus Citedby
https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85085854291&origin=inward
ID情報
  • DOI : 10.1302/0301-620X.102B6.BJJ-2019-1531.R1
  • ISSN : 2049-4394
  • eISSN : 2049-4408
  • PubMed ID : 32475263
  • SCOPUS ID : 85085854291

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