Control of paradoxical kinematics in posterior cruciate-retaining total knee arthroplasty by increasing posterior femoral offset

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
J DonadioPhilippe Massin

Abstract

Balancing the posterior cruciate ligament (PCL) with posterior cruciate-retaining total knee replacement (PCR-TKR) aims to restore femoral rollback. In practice, paradoxical roll forward persists. The purpose of this study is to propose a technique for optimizing PCL tension. Because PCL function starts above 60° of flexion, we hypothesize that PCL balancing requires flexion gap tightening by oversizing the femoral component and increasing posterior condylar offset (PCO). PCR-TKR was performed in 21 osteoarthritis patients with a gap-balancing technique. The femoral component was oversized if more than a 5-mm posterior drawer existed after tibial component implantation. Kinematics was recorded intra-operatively in two steps with dedicated navigation software (Praxim, La Tronche, Isère, France): antero-posterior (AP) displacements of condylo-tibial contact points were observed in native and implanted knees, with each knee serving as its own control. The absence of paradoxical displacements was verified once the final implants were inserted. Paradoxical medial condyle displacement (11 mm) persisted in a single case. On average, posterior displacement of the medial condyle decreased from 9 ± 9 to 1 ± 6 mm (p = 0.001) and that of t...Continue Reading

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May 17, 2013·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·G J P GeijsenA B Wymenga
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Jan 28, 2014·Orthopaedics & Traumatology, Surgery & Research : OTSR·H DejourP Chambat

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Citations

Jan 30, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Hans A GrayMarcus G Pandy
Jun 27, 2019·Scientific Reports·Philippe MoewisGeorg N Duda
Mar 22, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Marco A MarraAte B Wymenga
Jun 29, 2017·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Tilman PfitznerGeorg N Duda
Nov 21, 2020·The Journal of Arthroplasty·Lauren A SmithRichard D Komistek
May 23, 2021·Archives of Orthopaedic and Trauma Surgery·Ingrid DuprazArnd Steinbrück

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