J Knee Surg 2023; 36(08): 857-865
DOI: 10.1055/s-0042-1744191
Original Article

Both Intraoperative Medial and Lateral Joint Stabilities at Midflexion Influence Postoperative Patient-Reported Outcome Measures Following Bi-Cruciate Stabilized Total Knee Arthroplasty

Kentaro Takagi
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Shuji Taketomi
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Ryota Yamagami
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Kouhei Kawaguchi
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Shin Sameshima
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Tomofumi Kage
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Sakae Tanaka
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
,
Hiroshi Inui
1   Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
› Author Affiliations

Abstract

Bi-cruciate stabilized (BCS) total knee arthroplasty (TKA) was developed to approximate normal knee kinematics and is expected to improve clinical outcomes. However, the effects of soft tissue balance at the medial or lateral compartment on patient-reported outcome measures (PROMs) following BCS TKA are unclear. The purpose of this study was to clarify the relationship between the medial or lateral component gaps and PROMs following BCS TKA. One hundred seventeen knees with varus deformities which underwent BCS TKA were included in this study. They were divided into two groups according to the validated Japanese version of the Knee Injury and Osteoarthritis Outcome Score for each subscale of pain, symptoms, and activities of daily living (ADL) at 1 year postoperatively: group H consisted of patients with ≥90 points and group L consisted of patients with <90 points. Intraoperative medial and lateral joint laxities at 0°, 30°, 60°, 90°, and 120° flexion measured using a tensor device were compared between the two groups in each subscale. In the pain subscale, the medial joint laxities at 30° (p < 0.05) and 60° flexion (p < 0.05) in group H were significantly smaller than those in group L. In the ADL subscale, the medial joint laxity at 60° flexion in group H was significantly smaller than that in group L (p < 0.05). In the symptom subscale, the lateral joint laxity at 60° flexion in group H was significantly smaller than that in group L (p < 0.05). Surgeons should pay attention to the importance of both medial and lateral joint stabilities to achieve better postoperative PROMs following BCS TKA.



Publication History

Received: 07 August 2020

Accepted: 25 January 2022

Article published online:
08 March 2022

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