caa a22 4500 605456399 CHVBK 20210128100217.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s00167-015-3572-1 doi (NATIONALLICENCE)springer-10.1007/s00167-015-3572-1 Factors affecting intraoperative kinematic patterns and flexion angles in navigated total knee arthroplasty [Elektronische Daten] [Kazunari Ishida, Nao Shibanuma, Tomoyuki Matsumoto, Hiroshi Sasaki, Koji Takayama, Akihiko Toda, Ryosuke Kuroda, Masahiro Kurosaka] Purpose: To investigate the factors affecting intraoperative kinematics, as measured with a navigation system, and their effect on maximum flexion angles during total knee arthroplasty (TKA). Method: One hundred posterior stabilised (PS) TKAs performed using an image-free navigation system were evaluated. Tibial internal rotation angles at maximum extension, 30°, 45°, 60°, 90°, and maximum flexion were collected at registration and after implantation. The varus angles from the coronal mechanical axis were also collected. The rotational patterns were divided into four groups to investigate whether flexion contracture and varus deformity affected the kinematic patterns, and correlated with the maximum pre- and post-operative flexion angles. Results: At registration, the flexion angles at maximum extension differed significantly between the kinematic groups; the flexion angle at maximum extension at registration was negatively correlated with the pre-operative maximum flexion angle (R 2=0.226, p<0.0001) and the post-operative maximum flexion angle (R 2=0.059, p=0.0167). Varus deformity at registration also differed significantly between the kinematic groups; varus deformity at registration was negatively correlated with the pre-operative maximum flexion angle (R 2=0.087, p=0.0036) and post-operative maximum flexion angle (R 2=0.101, p=0.0027). Conclusion: Navigation-based measurements in patients undergoing PS TKA indicated that pre-operative flexion contracture and varus deformity are negatively correlated with both pre- and post-operative maximum flexion angles. The results may improve the ease with which surgeons can interpret intraoperative kinematics, by providing a multi-dimensional perspective. With further knowledge regarding intraoperative kinematics, it might be possible to improve surgical approach, prosthesis design, and clinical outcomes. Level of evidence: II. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2015 Total knee arthroplasty nationallicence Navigation nationallicence Kinematics nationallicence Maximum flexion angle nationallicence Flexion contracture nationallicence Varus deformity nationallicence Ishida Kazunari Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, 657-0068, Kobe, Japan aut Shibanuma Nao Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, 657-0068, Kobe, Japan aut Matsumoto Tomoyuki Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki, Chuo, 650-0017, Kobe, Japan aut Sasaki Hiroshi Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, 657-0068, Kobe, Japan aut Takayama Koji Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki, Chuo, 650-0017, Kobe, Japan aut Toda Akihiko Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, 657-0068, Kobe, Japan aut Kuroda Ryosuke Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki, Chuo, 650-0017, Kobe, Japan aut Kurosaka Masahiro Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki, Chuo, 650-0017, Kobe, Japan aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/6(2015-06-01), 1741-1747 0942-2056 23:6<1741 2015 23 167 https://doi.org/10.1007/s00167-015-3572-1 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-015-3572-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ishida Kazunari Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, 657-0068, Kobe, Japan aut NATIONALLICENCE 700 1- Shibanuma Nao Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, 657-0068, Kobe, Japan aut NATIONALLICENCE 700 1- Matsumoto Tomoyuki Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki, Chuo, 650-0017, Kobe, Japan aut NATIONALLICENCE 700 1- Sasaki Hiroshi Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, 657-0068, Kobe, Japan aut NATIONALLICENCE 700 1- Takayama Koji Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki, Chuo, 650-0017, Kobe, Japan aut NATIONALLICENCE 700 1- Toda Akihiko Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, 657-0068, Kobe, Japan aut NATIONALLICENCE 700 1- Kuroda Ryosuke Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki, Chuo, 650-0017, Kobe, Japan aut NATIONALLICENCE 700 1- Kurosaka Masahiro Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki, Chuo, 650-0017, Kobe, Japan aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/6(2015-06-01), 1741-1747 0942-2056 23:6<1741 2015 23 167