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  • Georg Thieme Verlag KG  (2)
  • Kuroda, Yuichi  (2)
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  • Georg Thieme Verlag KG  (2)
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  • 1
    In: The Journal of Knee Surgery, Georg Thieme Verlag KG, Vol. 34, No. 09 ( 2021-07), p. 930-935
    Abstract: Since a hindfoot alignment is not included in the conventional mechanical axis (hip–ankle [HA] line), a mechanical axis including the calcaneus (hip–calcaneus [HC] line) has recently attracted attention as an alternative weight-bearing line. However, there are few reports on unicompartmental knee arthroplasty (UKA) regarding the HC line. Therefore, this study aimed to compare postoperative alignments after UKA between the HA line and the HC line. Postoperatively, HC radiographs were taken in 88 consecutive patients who underwent medial UKA. The hip–knee–ankle (HKA) and hip–knee–calcaneus (HKC) angles were compared in the same patient. Regarding tibial inclination, the conventional tibial component–ankle (TCA) angle was compared with reference to the HC line (tibial component–calcaneus [TCC] angle). The mean postoperative HKA and HKC angles were 2.8 ± 2.7 and 2.0 ± 2.5 degree, respectively. The mean postoperative TCA and TCC angles were 87.7 ± 2.1 and 88.5 ± 2.1 degree, respectively. There were significant differences between the two groups in both lower limb alignment and tibial component angle. The present study indicated that the HKC and the TCC angles significantly decreased the varus alignment by approximately 1 degree compared with the HKA and TCA angles. Neutral in the HA line corresponds to valgus in reference to the HC line, which may result in overcorrection. Surgeons should consider evaluating the HC line in place of the HA line, which may affect preoperative planning and postoperative outcome during UKA. This is a Level II, diagnostic study.
    Type of Medium: Online Resource
    ISSN: 1538-8506 , 1938-2480
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
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  • 2
    In: The Journal of Knee Surgery, Georg Thieme Verlag KG, Vol. 33, No. 08 ( 2020-08), p. 777-784
    Abstract: Recently, kinematically aligned total knee arthroplasty has been found to achieve better clinical outcomes than mechanically aligned TKA. Despite the good clinical outcomes that are reported at short- to mid-term follow-up, intraoperative variables that are associated with a better outcome have not been measured. Therefore, this study was conducted to compare intraoperative kinematics/soft tissue balance and the clinical outcomes of patients who underwent modified kinematically (restricted tibial cut) or mechanically aligned total knee arthroplasty. Sixty cruciate-retaining total knee arthroplasties (30 modified kinematically [3-degree varus and 7-degree posterior slope in tibial cut] and 30 mechanically aligned) were performed in patients with varus-type osteoarthritis using a navigation system. Intraoperative kinematics assessed by the navigation system and soft tissue balance assessed by an offset-type tensor were compared between the groups. One year postoperatively, the range of motion and 2011 Knee Society scores were compared between the groups. Kinematic assessment exhibited that tibial internal rotation during flexion was significantly maintained in the kinematic compared with the mechanical group (p  〈  0.05). Varus/valgus ligament balance at 90 and 120 degrees of flexion significantly maintained lateral laxity in the kinematic compared with the mechanical group (p  〈  0.05). Improvement of flexion angles, functional activity scores, and patient satisfaction were significantly better in the kinematic than in the mechanical group (p  〈  0.05). Modified kinematically aligned cruciate-retaining total knee arthroplasty maintained more tibial internal rotation and lateral laxity during flexion than mechanically aligned total knee arthroplasty; thus, the former may result in better clinical outcomes.
    Type of Medium: Online Resource
    ISSN: 1538-8506 , 1938-2480
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2020
    Location Call Number Limitation Availability
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