Partial and combined partial knee arthroplasty: greater anterior-posterior stability than posterior-cruciate retaining total knee arthroplasty
File(s)Manuscript Final.pdf (1.16 MB)
Accepted version
Author(s)
Garner, Amy
Dandridge, Oliver
Amis, Andrew
Cobb, Justin
van Arkel, Richard
Type
Journal Article
Abstract
Background
Little is known regarding anterior-posterior stability after anterior cruciate ligament–preserving partial (PKA) and combined partial knee arthroplasty (CPKA) compared to standard posterior cruciate–retaining total knee arthroplasty (TKA).
Methods
The anterior-posterior tibial translation of twenty-four cadaveric knees was measured, with optical tracking, while under 90N drawer with the knee flexed 0-90°. Knees were tested before and after PKA, CPKA (medial and lateral bicompartmental and bi-unicondylar), and then posterior cruciate–retaining TKA. The anterior-posterior tibial translations of the arthroplasty states, at each flexion angle, were compared to the native knee and each other with repeated measures analyses of variance and post-hoc t-tests.
Results
Unicompartmental and bicompartmental arthroplasty states had similar laxities to the native knee and to each other, with ≤1-mm differences throughout the flexion range (P ≥ .199). Bi-unicondylar arthroplasty resulted in 6- to 8-mm increase of anterior tibial translation at high flexion angles compared to the native knee (P ≤ .023 at 80-90°). Meanwhile, TKA exhibited increased laxity across all flexion angles, with increased anterior tibial translation of up to 18 ± 6 mm (P < .001) and increased posterior translation of up to 4 ± 2 mm (P < .001).
Conclusions
In a cadaveric study, anterior-posterior tibial translation did not differ from native laxity after PKA and CPKA. Posterior cruciate ligament–preserving TKA demonstrated increased laxity, particularly in anterior tibial translation.
Little is known regarding anterior-posterior stability after anterior cruciate ligament–preserving partial (PKA) and combined partial knee arthroplasty (CPKA) compared to standard posterior cruciate–retaining total knee arthroplasty (TKA).
Methods
The anterior-posterior tibial translation of twenty-four cadaveric knees was measured, with optical tracking, while under 90N drawer with the knee flexed 0-90°. Knees were tested before and after PKA, CPKA (medial and lateral bicompartmental and bi-unicondylar), and then posterior cruciate–retaining TKA. The anterior-posterior tibial translations of the arthroplasty states, at each flexion angle, were compared to the native knee and each other with repeated measures analyses of variance and post-hoc t-tests.
Results
Unicompartmental and bicompartmental arthroplasty states had similar laxities to the native knee and to each other, with ≤1-mm differences throughout the flexion range (P ≥ .199). Bi-unicondylar arthroplasty resulted in 6- to 8-mm increase of anterior tibial translation at high flexion angles compared to the native knee (P ≤ .023 at 80-90°). Meanwhile, TKA exhibited increased laxity across all flexion angles, with increased anterior tibial translation of up to 18 ± 6 mm (P < .001) and increased posterior translation of up to 4 ± 2 mm (P < .001).
Conclusions
In a cadaveric study, anterior-posterior tibial translation did not differ from native laxity after PKA and CPKA. Posterior cruciate ligament–preserving TKA demonstrated increased laxity, particularly in anterior tibial translation.
Date Issued
2021-11
Date Acceptance
2021-06-21
Citation
The Journal of Arthroplasty, 2021, 36 (11), pp.3765-3772.e4
ISSN
0883-5403
Publisher
Elsevier BV
Start Page
3765
End Page
3772.e4
Journal / Book Title
The Journal of Arthroplasty
Volume
36
Issue
11
Copyright Statement
© 2021 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor
Engineering & Physical Science Research Council (EPSRC)
The Sackler Foundation
Identifier
https://www.sciencedirect.com/science/article/pii/S0883540321005854?via%3Dihub
Grant Number
N/A
WSSU_P74159
Subjects
Science & Technology
Life Sciences & Biomedicine
Orthopedics
stability
anterior cruciate ligament
unicompartmental
bi-compartmental
bi-unicondylar
total knee arthroplasty
NATIONAL JOINT REGISTRY
MATCHED PATIENTS
LIGAMENT
OUTCOMES
LAXITY
REPLACEMENT
INSTABILITY
MOTION
ACL
ANTEROPOSTERIOR
anterior cruciate ligament
bi-compartmental
bi-unicondylar
stability
total knee arthroplasty
unicompartmental
Anterior Cruciate Ligament
Arthroplasty, Replacement, Knee
Biomechanical Phenomena
Humans
Knee Joint
Posterior Cruciate Ligament
0903 Biomedical Engineering
1103 Clinical Sciences
Orthopedics
Publication Status
Published
Date Publish Online
2021-06-29