Highlights
- •Knee alignment and laxity before, during and after knee arthroplasty were determined.
- •No difference in coronal alignment was evident.
- •Greater knee extension occurred intra-operatively than in the clinic.
Abstract
Background
This study compared knee alignment and laxity in patients before, during and after
total knee arthroplasty, using methodologically similar procedures, with an aim to
help inform pre-operative planning.
Methods
Eighteen male and 13 female patients were recruited, mean age 66 years (51–82) and mean body mass index of 33 (23–43). All were assessed pre- and postoperatively
using a non-invasive infrared position capture system and all underwent total knee
arthroplasty using a navigation system. Knee kinematic data were collected and comparisons
made between preoperative clinical and intraoperative measurements for osteoarthritic
knees, and between postoperative clinical and intraoperative measurements for prosthetic
knees.
Findings
There was no difference in unstressed coronal mechanical femoral-tibial angles for
either osteoarthritic or prosthetic knees. However, for sagittal alignment the knees
were in greater extension intraoperatively (osteoarthritic 5.2° p < 0.001, prosthetic 7.2° p < 0.001). For osteoarthritic knees, both varus and valgus stress manoeuvres had greater
angular displacements intraoperatively by a mean value of 1.5° for varus (p = 0.002) and 1.6° for valgus (p < 0.001). For prosthetic knees, only valgus angular displacement was greater intraoperatively
(0.9°, p = 0.002).
Interpretation
Surgeons performing total knee arthroplasties should be aware of potential differences
in alignment and laxity measured under different conditions to facilitate more accurate
operative planning and follow-up.
Keywords
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Article info
Publication history
Published online: May 26, 2017
Accepted:
May 25,
2017
Received:
June 18,
2016
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
