Florian Baumann1, Özkan Bahadin2, Werner Krutsch3, Johannes Zellner3, Michael Nerlich3, Peter Angele3,2, Carsten Oliver Tibesku4. 1. Department of Trauma Surgery, Regensburg University Medical Center, Regensburg, Germany. florian.baumann@ukr.de. 2. Sporthopaedicum Regensburg, Hildegard-vn-Bingen-Str. 1, 93053, Regensburg, Germany. 3. Department of Trauma Surgery, Regensburg University Medical Center, Regensburg, Germany. 4. Sporthopaedicum Straubing, Bahnhofsplatz 27, 94315, Straubing, Germany.
Abstract
PURPOSE: Rising expectations in functional performance of total knee joints are inciting further improvement of knee arthroplasty implants. From a patient-centred view, bicruciate-retaining models provide a more natural feeling knee. However, there is no evidence of functional advantage for these implants. The aim of this study was to evaluate balance ability as a measure of proprioception in patients with a bicruciate-retaining total knee arthroplasty. METHODS: A prospective, controlled trial was conducted to compare balance ability in 60 patients after arthroplasty of the knee for osteoarthritis. We compared patients with a bicruciate-retaining knee arthroplasty (BCR group) to a control group of patients with a medial unicompartmental knee arthroplasty (UKA group) and another control group of patients with a posterior stabilized total knee arthroplasty (PS group). The patient population comprised 30 women (50.0 %) and 30 men in three cohorts of 20 each. The mean age was 62.1 ± 8.0 years (range 43-78). Patients were evaluated preoperatively and 9 months post-operatively. The evaluation included clinical, radiological, and balance testing-a single-leg stance with eyes closed compared to eyes open. The difference in area of sway between eyes closed and eyes open represents static balance abilityafter knee arthroplasty. RESULTS: Perioperative data showed that there was no intra-operative fracture of the intercondylar eminence. There was a decreased post-operative knee extension 9 months post-operative in the BCR group, which was not clinically relevant in any case. We recorded a lower difference in the area of sway between eyes closed and eyes open (ΔA (ec-eo)) for the BCR group (p = 0.01) and the UKA group (p = 0.04) compared to the PS group. CONCLUSIONS: This study found superior static balance ability after preservation of both cruciate ligaments in arthroplasty of the knee, indicating superior proprioceptive function. Hence, BCR implants could provide improved functional properties. Superior proprioceptive function of bicruciate-retaining implants can be an important factor in implant selection. Further prospective, randomized studies to investigate kinematics and long-term survivorship of bicruciate-retaining implants are needed. LEVEL OF EVIDENCE: II.
RCT Entities:
PURPOSE: Rising expectations in functional performance of total knee joints are inciting further improvement of knee arthroplasty implants. From a patient-centred view, bicruciate-retaining models provide a more natural feeling knee. However, there is no evidence of functional advantage for these implants. The aim of this study was to evaluate balance ability as a measure of proprioception in patients with a bicruciate-retaining total knee arthroplasty. METHODS: A prospective, controlled trial was conducted to compare balance ability in 60 patients after arthroplasty of the knee for osteoarthritis. We compared patients with a bicruciate-retaining knee arthroplasty (BCR group) to a control group of patients with a medial unicompartmental knee arthroplasty (UKA group) and another control group of patients with a posterior stabilized total knee arthroplasty (PS group). The patient population comprised 30 women (50.0 %) and 30 men in three cohorts of 20 each. The mean age was 62.1 ± 8.0 years (range 43-78). Patients were evaluated preoperatively and 9 months post-operatively. The evaluation included clinical, radiological, and balance testing-a single-leg stance with eyes closed compared to eyes open. The difference in area of sway between eyes closed and eyes open represents static balance ability after knee arthroplasty. RESULTS: Perioperative data showed that there was no intra-operative fracture of the intercondylar eminence. There was a decreased post-operative knee extension 9 months post-operative in the BCR group, which was not clinically relevant in any case. We recorded a lower difference in the area of sway between eyes closed and eyes open (ΔA (ec-eo)) for the BCR group (p = 0.01) and the UKA group (p = 0.04) compared to the PS group. CONCLUSIONS: This study found superior static balance ability after preservation of both cruciate ligaments in arthroplasty of the knee, indicating superior proprioceptive function. Hence, BCR implants could provide improved functional properties. Superior proprioceptive function of bicruciate-retaining implants can be an important factor in implant selection. Further prospective, randomized studies to investigate kinematics and long-term survivorship of bicruciate-retaining implants are needed. LEVEL OF EVIDENCE: II.
Authors: S Fuchs; C O Tibesku; D Frisse; M Genkinger; H Laass; D Rosenbaum Journal: Knee Surg Sports Traumatol Arthrosc Date: 2004-12-24 Impact factor: 4.342
Authors: Richard D Komistek; Jerome Allain; Dylan T Anderson; Douglas A Dennis; Daniel Goutallier Journal: Clin Orthop Relat Res Date: 2002-11 Impact factor: 4.176
Authors: Abderrahman Ouattas; Elizabeth Wellsandt; Nathaniel H Hunt; C Kent Boese; Brian A Knarr Journal: Clin Biomech (Bristol, Avon) Date: 2019-06-14 Impact factor: 2.063
Authors: Hannah A Wilson; Rob Middleton; Simon G F Abram; Stephanie Smith; Abtin Alvand; William F Jackson; Nicholas Bottomley; Sally Hopewell; Andrew J Price Journal: BMJ Date: 2019-02-21