Does navigated patellar resurfacing in total knee arthroplasty result in proper bone cut, motion and clinical outcomes?

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Abstract

[Indexed for MEDLINE] 7. Knee Surg Sports Traumatol Arthrosc. 2016 Aug;24(8):2447-52. doi: 10.1007/s00167-016-4008-2. Epub 2016 Feb 4. Navigation-based tibial rotation at 90° of flexion is associated with better range of motion in navigated total knee arthroplasty. Ishida K(1), Shibanuma N(2), Matsumoto T(3), Sasaki H(2), Takayama K(3), Hiroshima Y(3), Kuroda R(3), Kurosaka M(3). Author information: (1)Department of Orthopedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, Kobe, 657-0068, Japan. wavedreamer17@yahoo.co.jp. (2)Department of Orthopedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, Kobe, 657-0068, Japan. (3)Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki, Chuo, Kobe, 650-0017, Japan. PURPOSE: In clinical practice, people with better femorotibial rotation in the flexed position often achieve a favourable postoperative maximum flexion angle (MFA). However, no objective data have been reported to support this clinical observation. In the present study, we aimed to investigate the correlation between the amount of intraoperative rotation and the pre- and postoperative flexion angles. METHODS: Fifty-five patients with varus osteoarthritis undergoing computer-assisted posterior-stabilized total knee arthroplasty (TKA) were enrolled. After registration, rotational stress was applied towards the knee joint, and the rotational angles were recorded by using a navigation system at maximum extension and 90° of flexion. After implantation, rotational stress was applied for a second time, and the angles were recorded once more. The MFA was measured before surgery and 1 month after surgery, and the correlation between the amount of femorotibial rotation during surgery and the MFA was statistically evaluated. RESULTS: Although the amount of tibial rotation at maximum extension was not correlated with the MFA, the amount of tibial rotation at 90° of flexion after registration was positively correlated with the pre- and postoperative MFA (both p