Abstract
Mechanical alignment in total knee arthroplasty (TKA) can be achieved using dependent
bone cuts. The hypothesis is that patients have a better balanced TKA, as a result.
The aim of this study was to determine if this technique is superior to an independent
bone cut technique in terms of gait parameters, patient-reported outcome measures
(PROMs), and satisfaction assessed before surgery and at 1-year follow-up. A total
of 58 patients were evaluated before and 1 year following TKA, using the Press Fit
Condylar (PFC) Sigma posterior stabilizer (PS) design; 39 (70 ± 8 years; 27 women)
with independent bone cuts and 19 (71 ± 7 years; 12 women) with dependent bone cuts
using the Specialist TRAM. Gait was evaluated with a three-dimensional motion analysis
system for spatiotemporal and kinematics parameters. Pain and functional levels were
assessed using the Western Ontario and McMaster Universities arthritis index (WOMAC);
general health was assessed by the short form (SF)-12. Global satisfaction, as well
as patient satisfaction, related to pain and functional levels were assessed using
a five-point Likert's scale. No significant difference was found between both groups
in terms of age, body mass index, pain, and functional levels at baseline. At 1-year
follow-up, despite an overall improvement in gait, WOMAC, SF-12 physical score and
pain, none of the patients showed gait parameters comparable to a healthy control
group. No surgical technique effect was observed on gait, clinical outcomes, and satisfaction
level. While observing an overall improvement at 1-year follow-up, we did not find
any significant difference between the two surgical techniques in terms of gait parameters,
patients' outcomes, and satisfaction.
Keywords
osteoarthritis - total knee arthroplasty - knee kinematics - gait analysis - PROMs
- gap balancing - resection technique
