Medial pivot total knee arthroplasty for valgus knees provides equivalent medial stability compared to that for varus knees: In vivo kinematic study

Abstract Purpose The efficacy of medial pivot total knee arthroplasty (MP TKA) in treating valgus knees that may cause medial instability is unknown. The purpose of this study was to investigate the in vivo kinematics of MP TKA for the valgus knees and compare them to those for the varus knees. Meth...

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Main Authors: Tomofumi Kage, Kenichi Kono, Tetsuya Tomita, Takaharu Yamazaki, Shuji Taketomi, Ryota Yamagami, Kohei Kawaguchi, Ryo Murakami, Takahiro Arakawa, Takashi Kobayashi, Hiroshi Inui, Sakae Tanaka
Format: Article
Language:English
Published: Wiley 2024-10-01
Series:Journal of Experimental Orthopaedics
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Online Access:https://doi.org/10.1002/jeo2.70013
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author Tomofumi Kage
Kenichi Kono
Tetsuya Tomita
Takaharu Yamazaki
Shuji Taketomi
Ryota Yamagami
Kohei Kawaguchi
Ryo Murakami
Takahiro Arakawa
Takashi Kobayashi
Hiroshi Inui
Sakae Tanaka
author_facet Tomofumi Kage
Kenichi Kono
Tetsuya Tomita
Takaharu Yamazaki
Shuji Taketomi
Ryota Yamagami
Kohei Kawaguchi
Ryo Murakami
Takahiro Arakawa
Takashi Kobayashi
Hiroshi Inui
Sakae Tanaka
author_sort Tomofumi Kage
collection DOAJ
description Abstract Purpose The efficacy of medial pivot total knee arthroplasty (MP TKA) in treating valgus knees that may cause medial instability is unknown. The purpose of this study was to investigate the in vivo kinematics of MP TKA for the valgus knees and compare them to those for the varus knees. Methods The kinematics of 19 valgus knees and 19 varus knees operated in the MP TKA were investigated under fluoroscopy during squatting using a two‐ to three‐dimensional registration technique. Accordingly, the valgus and varus knees were evaluated and compared in terms of knee flexion angle, anteroposterior translation for the medial and lateral low contact points, axial rotation and valgus–varus angle of the femoral component relative to the tibial component, as well as kinematic pathways. Results The knee flexion angle was found to be identical in both knees. There was no anterior translation on the medial side of the valgus knees, and no difference was detected between the two knees. On the lateral side, posterior translation was observed in both knees, with no difference between the two. Femoral external rotation was observed in both knees, and no difference was detected between the two. There was no valgus–varus change in the valgus knees, nor was there a difference between the two knees. The valgus knees demonstrated MP motion, whereas the varus knees demonstrated MP motion and bicondylar rollback. Conclusion The medial side of the valgus knees treated with MP TKA showed comparable stable kinematics to the varus knees. The MP TKA is an effective procedure for valgus knees to stabilize the medial compartment. Level of Evidence Level Ⅲ.
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spelling doaj-art-8cb6902d809b4fe780eb3e612d1cb4d32025-08-20T02:58:21ZengWileyJournal of Experimental Orthopaedics2197-11532024-10-01114n/an/a10.1002/jeo2.70013Medial pivot total knee arthroplasty for valgus knees provides equivalent medial stability compared to that for varus knees: In vivo kinematic studyTomofumi Kage0Kenichi Kono1Tetsuya Tomita2Takaharu Yamazaki3Shuji Taketomi4Ryota Yamagami5Kohei Kawaguchi6Ryo Murakami7Takahiro Arakawa8Takashi Kobayashi9Hiroshi Inui10Sakae Tanaka11Department of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Bunkyo‐ku Tokyo JapanDepartment of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Bunkyo‐ku Tokyo JapanGraduate School of Health Sciences Morinomiya University of Medical Sciences Osaka JapanDepartment of Information Systems, Faculty of Engineering Saitama Institute of Technology Fukaya Saitama JapanDepartment of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Bunkyo‐ku Tokyo JapanDepartment of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Bunkyo‐ku Tokyo JapanDepartment of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Bunkyo‐ku Tokyo JapanDepartment of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Bunkyo‐ku Tokyo JapanDepartment of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Bunkyo‐ku Tokyo JapanDepartment of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Bunkyo‐ku Tokyo JapanDepartment of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Bunkyo‐ku Tokyo JapanDepartment of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Bunkyo‐ku Tokyo JapanAbstract Purpose The efficacy of medial pivot total knee arthroplasty (MP TKA) in treating valgus knees that may cause medial instability is unknown. The purpose of this study was to investigate the in vivo kinematics of MP TKA for the valgus knees and compare them to those for the varus knees. Methods The kinematics of 19 valgus knees and 19 varus knees operated in the MP TKA were investigated under fluoroscopy during squatting using a two‐ to three‐dimensional registration technique. Accordingly, the valgus and varus knees were evaluated and compared in terms of knee flexion angle, anteroposterior translation for the medial and lateral low contact points, axial rotation and valgus–varus angle of the femoral component relative to the tibial component, as well as kinematic pathways. Results The knee flexion angle was found to be identical in both knees. There was no anterior translation on the medial side of the valgus knees, and no difference was detected between the two knees. On the lateral side, posterior translation was observed in both knees, with no difference between the two. Femoral external rotation was observed in both knees, and no difference was detected between the two. There was no valgus–varus change in the valgus knees, nor was there a difference between the two knees. The valgus knees demonstrated MP motion, whereas the varus knees demonstrated MP motion and bicondylar rollback. Conclusion The medial side of the valgus knees treated with MP TKA showed comparable stable kinematics to the varus knees. The MP TKA is an effective procedure for valgus knees to stabilize the medial compartment. Level of Evidence Level Ⅲ.https://doi.org/10.1002/jeo2.70013in vivo kinematicsmedial pivot total knee arthroplastyvalgus kneesvarus knees
spellingShingle Tomofumi Kage
Kenichi Kono
Tetsuya Tomita
Takaharu Yamazaki
Shuji Taketomi
Ryota Yamagami
Kohei Kawaguchi
Ryo Murakami
Takahiro Arakawa
Takashi Kobayashi
Hiroshi Inui
Sakae Tanaka
Medial pivot total knee arthroplasty for valgus knees provides equivalent medial stability compared to that for varus knees: In vivo kinematic study
Journal of Experimental Orthopaedics
in vivo kinematics
medial pivot total knee arthroplasty
valgus knees
varus knees
title Medial pivot total knee arthroplasty for valgus knees provides equivalent medial stability compared to that for varus knees: In vivo kinematic study
title_full Medial pivot total knee arthroplasty for valgus knees provides equivalent medial stability compared to that for varus knees: In vivo kinematic study
title_fullStr Medial pivot total knee arthroplasty for valgus knees provides equivalent medial stability compared to that for varus knees: In vivo kinematic study
title_full_unstemmed Medial pivot total knee arthroplasty for valgus knees provides equivalent medial stability compared to that for varus knees: In vivo kinematic study
title_short Medial pivot total knee arthroplasty for valgus knees provides equivalent medial stability compared to that for varus knees: In vivo kinematic study
title_sort medial pivot total knee arthroplasty for valgus knees provides equivalent medial stability compared to that for varus knees in vivo kinematic study
topic in vivo kinematics
medial pivot total knee arthroplasty
valgus knees
varus knees
url https://doi.org/10.1002/jeo2.70013
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