scholarly journals Posterior condylar offset changes and its effect on clinical outcomes after posterior-substituting, fixed-bearing total knee arthroplasty: anterior versus posterior referencing

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Moon Jong Chang ◽  
Seung-Baik Kang ◽  
Chong Bum Chang ◽  
Do Hwan Han ◽  
Hyung Jun Park ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Linear Regression Analysis ◽  
Trial Registration ◽  
Fixed Bearing ◽  
Posterior Condylar Offset ◽  
Posterior Condylar ◽  
Total Knee

Abstract Background We sought to determine whether there was a difference in the posterior condylar offset (PCO), posterior condylar offset ratio (PCOR) and clinical outcomes following total knee arthroplasty (TKA) with anterior referencing (AR) or posterior referencing (PR) systems. We also assessed whether the PCO and PCOR changes, as well as patient factors were related to range of motion (ROM) in each referencing system. Methods This retrospective study included 130 consecutive patients (184 knees) with osteoarthritis who underwent primary posterior cruciate ligament (PCL)-substituting fixed-bearing TKA. The difference between preoperative and postoperative PCO and PCOR values were calculated. Clinical outcomes including ROM and Western Ontario and McMaster University (WOMAC) scores were evaluated. Furthermore, multiple linear regression analysis was performed to determine the factors related to postoperative ROM in each referencing system. Results The postoperative PCO was greater in the AR group (28.4 mm) than in the PR group (27.4 mm), whereas the PCO was more consistently preserved in the PR group. The mean postoperative ROM after TKA was greater in the AR group (129°) than in the PR group (122°), whereas improvement in WOMAC score did not differ between the two groups. Preoperative ROM was the only factor related to postoperative ROM in both groups. Conclusions There was no difference in postoperative PCO in AR and PR group and the PCO was not associated with postoperative ROM. PCO was more consistently preserved after surgery in the PR group. The postoperative PCO and PCOR changes did not affect the postoperative ROM. Furthermore, similar clinical outcomes were achieved in the AR and PR groups. Trial registration Retrospectively registered (Trial registration number: 06-2010-110).

Does Posterior Condylar Offset Affect Clinical Results following Total Knee Arthroplasty?

2017 ◽  
Vol 31 (08) ◽  
pp. 754-760 ◽  
Author(s):  
Ryan Degen ◽  
Jacob Matz ◽  
Matthew Teeter ◽  
Brent Lanting ◽  
James Howard ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Outcome Measures ◽  
Knee Arthroplasty ◽  
Short Form ◽  
Clinical Results ◽  
Patient Reported Outcome Measures ◽  
Posterior Condylar Offset ◽  
Patient Reported ◽  
Posterior Condylar ◽  
Total Knee

AbstractTotal knee arthroplasty (TKA) is an effective, durable treatment for knee osteoarthritis. However, a subset of patients experiences incomplete pain relief and ongoing dysfunction. Posterior condylar offset (PCO) has previously been shown to be associated with postoperative range of motion (ROM) following TKA; however, an association with patient-reported outcome measures (PROMs) has not been established. The purpose of this study was to evaluate the association between PCO and postoperative ROM and PROMs. A retrospective review of 970 posterior-stabilized single design TKAs was performed. Preoperative and postoperative radiographs were analyzed to measure the change in PCO and anteroposterior (AP) femoral dimension. Clinical outcome measures, including Short Form-12 physical and mental component summaries, Western Ontario and McMaster Universities Arthritis Index, and Knee Society Score were reviewed to determine if these were influenced by changes in PCO and AP dimension. PCO was increased by more than 3 mm in 15.1%, maintained (within 3 mm) in 59.6%, and decreased by more than 3 mm in 25.3% of patients. Comparing between these groups, there were no significant differences in postoperative ROM or PROM. AP dimension increased in 24.4%, maintained in 47.8%, and decreased in 27.8%. Similarly, there were no significant differences in ROM or PROM between these groups. Spearman's correlation analyses failed to identify an association between PCO and ROM or PROMs. In conclusion, increasing or decreasing PCO or AP femoral dimension with this PS TKA design did not significantly affect postoperative ROM or PROM. Similarly, maintenance of PCO within one implant size with this system compared with optimal sizing had no deleterious effect on TKA outcomes.

scholarly journals A computational simulation study to determine the biomechanical influence of posterior condylar offset and tibial slope in cruciate retaining total knee arthroplasty

2018 ◽  
Vol 7 (1) ◽  
pp. 69-78 ◽  
Author(s):  
K-T. Kang ◽  
Y-G. Koh ◽  
J. Son ◽  
O-R. Kwon ◽  
J-S. Lee ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Patellar Tendon ◽  
Contact Stress ◽  
Knee Arthroplasty ◽  
Computational Simulation ◽  
Tibial Slope ◽  
Cruciate Retaining ◽  
Posterior Condylar Offset ◽  
Posterior Condylar ◽  
Total Knee

ObjectivesPosterior condylar offset (PCO) and posterior tibial slope (PTS) are critical factors in total knee arthroplasty (TKA). A computational simulation was performed to evaluate the biomechanical effect of PCO and PTS on cruciate retaining TKA.MethodsWe generated a subject-specific computational model followed by the development of ± 1 mm, ± 2 mm and ± 3 mm PCO models in the posterior direction, and -3°, 0°, 3° and 6° PTS models with each of the PCO models. Using a validated finite element (FE) model, we investigated the influence of the changes in PCO and PTS on the contact stress in the patellar button and the forces on the posterior cruciate ligament (PCL), patellar tendon and quadriceps muscles under the deep knee-bend loading conditions.ResultsContact stress on the patellar button increased and decreased as PCO translated to the anterior and posterior directions, respectively. In addition, contact stress on the patellar button decreased as PTS increased. These trends were consistent in the FE models with altered PCO. Higher quadriceps muscle and patellar tendon force are required as PCO translated in the anterior direction with an equivalent flexion angle. However, as PTS increased, quadriceps muscle and patellar tendon force reduced in each PCO condition. The forces exerted on the PCL increased as PCO translated to the posterior direction and decreased as PTS increased.ConclusionThe change in PCO alternatively provided positive and negative biomechanical effects, but it led to a reduction in a negative biomechanical effect as PTS increased. Cite this article: K-T. Kang, Y-G. Koh, J. Son, O-R. Kwon, J-S. Lee, S. K. Kwon. A computational simulation study to determine the biomechanical influence of posterior condylar offset and tibial slope in cruciate retaining total knee arthroplasty. Bone Joint Res 2018;7:69–78. DOI: 10.1302/2046-3758.71.BJR-2017-0143.R1.

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