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Knee joint laxity is restored in a bi-cruciate retaining TKA-design

Nele Arnout (UGent) , Jan Victor (UGent) , Hannes Vermue (UGent) , Lauren Pringels (UGent) , Johan Bellemans and Matthias Verstraete (UGent)
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Abstract
Purpose The goal is to evaluate the passive stability of a bicruciate retaining, cruciate retaining and bicruciate substituting TKA design in relation to the native knee stability in terms of the laxity envelope. A bicruciate retaining knee prosthesis was hypothesized to offer a closer to normal knee stability in vitro. Methods Fourteen cadaveric knee specimens have been tested under passive conditions with and without external loads, involving a varus/valgus and an external/internal rotational torque, distraction/compression force and an anteroposterior shear force. Subsequently, the native knee, bicruciate retaining, cruciate retaining and finally a bicruciate substituting total knee arthroplasty were tested. Results Through the range of motion, the width of the varus/valgus and internal/external laxity envelope for the native knee and the bicruciate retaining knee were almost equivalent, whereas the cruciate retaining and the bicruciate substituting knee displayed less laxity and more joint distraction. In all prosthetic knees, an equal anteroposterior laxity was seen for the lateral and medial side whereas in the native knee, a difference in laxity was seen between the stable medial side and the more mobile lateral side. Conclusion Bicruciate retaining knee prostheses can restore normal laxity and thus have the potential to offer more normal knee function. Restoration of natural peri-articular soft-tissue tension is clinically important because of its obvious effects on joint stability and range of motion. Furthermore, the results of this study could help to establish the ideal ligament tension and laxity in more conventional implants by approaching the normal values for passive knee evaluation as presented here.
Keywords
Surgery, Orthopedics and Sports Medicine, Cruciate ligaments, Total knee arthroplasty, Knee laxity, PATIENT-REPORTED OUTCOMES, TIBIOFEMORAL JOINT, ARTHROPLASTY, REPLACEMENT, SURVIVORSHIP, SATISFACTION, BIOMECHANICS, KINEMATICS, YOUNGER

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MLA
Arnout, Nele, et al. “Knee Joint Laxity Is Restored in a Bi-Cruciate Retaining TKA-Design.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, vol. 28, no. 9, 2020, pp. 2863–71, doi:10.1007/s00167-019-05639-4.
APA
Arnout, N., Victor, J., Vermue, H., Pringels, L., Bellemans, J., & Verstraete, M. (2020). Knee joint laxity is restored in a bi-cruciate retaining TKA-design. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 28(9), 2863–2871. https://doi.org/10.1007/s00167-019-05639-4
Chicago author-date
Arnout, Nele, Jan Victor, Hannes Vermue, Lauren Pringels, Johan Bellemans, and Matthias Verstraete. 2020. “Knee Joint Laxity Is Restored in a Bi-Cruciate Retaining TKA-Design.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 28 (9): 2863–71. https://doi.org/10.1007/s00167-019-05639-4.
Chicago author-date (all authors)
Arnout, Nele, Jan Victor, Hannes Vermue, Lauren Pringels, Johan Bellemans, and Matthias Verstraete. 2020. “Knee Joint Laxity Is Restored in a Bi-Cruciate Retaining TKA-Design.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 28 (9): 2863–2871. doi:10.1007/s00167-019-05639-4.
Vancouver
1.
Arnout N, Victor J, Vermue H, Pringels L, Bellemans J, Verstraete M. Knee joint laxity is restored in a bi-cruciate retaining TKA-design. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 2020;28(9):2863–71.
IEEE
[1]
N. Arnout, J. Victor, H. Vermue, L. Pringels, J. Bellemans, and M. Verstraete, “Knee joint laxity is restored in a bi-cruciate retaining TKA-design,” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, vol. 28, no. 9, pp. 2863–2871, 2020.
@article{8627182,
  abstract     = {{Purpose The goal is to evaluate the passive stability of a bicruciate retaining, cruciate retaining and bicruciate substituting TKA design in relation to the native knee stability in terms of the laxity envelope. A bicruciate retaining knee prosthesis was hypothesized to offer a closer to normal knee stability in vitro. Methods Fourteen cadaveric knee specimens have been tested under passive conditions with and without external loads, involving a varus/valgus and an external/internal rotational torque, distraction/compression force and an anteroposterior shear force. Subsequently, the native knee, bicruciate retaining, cruciate retaining and finally a bicruciate substituting total knee arthroplasty were tested. Results Through the range of motion, the width of the varus/valgus and internal/external laxity envelope for the native knee and the bicruciate retaining knee were almost equivalent, whereas the cruciate retaining and the bicruciate substituting knee displayed less laxity and more joint distraction. In all prosthetic knees, an equal anteroposterior laxity was seen for the lateral and medial side whereas in the native knee, a difference in laxity was seen between the stable medial side and the more mobile lateral side. Conclusion Bicruciate retaining knee prostheses can restore normal laxity and thus have the potential to offer more normal knee function. Restoration of natural peri-articular soft-tissue tension is clinically important because of its obvious effects on joint stability and range of motion. Furthermore, the results of this study could help to establish the ideal ligament tension and laxity in more conventional implants by approaching the normal values for passive knee evaluation as presented here.}},
  author       = {{Arnout, Nele and Victor, Jan and Vermue, Hannes and Pringels, Lauren and Bellemans, Johan and Verstraete, Matthias}},
  issn         = {{0942-2056}},
  journal      = {{KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY}},
  keywords     = {{Surgery,Orthopedics and Sports Medicine,Cruciate ligaments,Total knee arthroplasty,Knee laxity,PATIENT-REPORTED OUTCOMES,TIBIOFEMORAL JOINT,ARTHROPLASTY,REPLACEMENT,SURVIVORSHIP,SATISFACTION,BIOMECHANICS,KINEMATICS,YOUNGER}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{2863--2871}},
  title        = {{Knee joint laxity is restored in a bi-cruciate retaining TKA-design}},
  url          = {{http://doi.org/10.1007/s00167-019-05639-4}},
  volume       = {{28}},
  year         = {{2020}},
}

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