Efficacy of functional alignment in total knee arthroplasty in restoring in vivo cruciate ligament forces and knee kinematics compared with mechanical alignment
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Le résumé fourni par la source
PURPOSE: The impact of coronal alignment on cruciate ligament forces in bicruciate-retaining total knee arthroplasty (TKA) remains unclear. We aimed to clarify in vivo cruciate ligament forces and knee kinematics among mechanically aligned (MA) and functionally aligned (FA) TKAs and normal knees. METHODS: Normal, MA TKA and FA TKA knees were assessed during squatting using fluoroscopy. Tibiofemoral kinematics was measured using a two-dimensional/three-dimensional registration technique, including axial rotation, varus-valgus angle, and anteroposterior translation (APT) of the surgical epicondylar axis (SEA) and low contact points (LCPs). Ligament tensions during knee flexion were analysed in the anteromedial anterior cruciate ligament (aACL) and posterolateral anterior cruciate ligament (pACL) and anterolateral posterior cruciate ligament (aPCL) and posteromedial posterior cruciate ligament (pPCL). RESULTS: Both MA and FA TKA knees exhibited greater external femoral rotation and less varus alignment. Medially, MA TKA knees were positioned more anteriorly at 0° flexion. Laterally, both TKA knees were positioned more posteriorly up to 10° flexion. Medially, MA TKA knees were positioned more anteriorly at 0° flexion. Laterally, both TKA knees were positioned more posteriorly up to 10° flexion. In lateral LCPs, both TKA knees were more anteriorly positioned. aACL and pACL tensions decreased with flexion, with no significant differences between TKA and normal knees, whereas aPCL and pPCL tensions increased with flexion. Beyond 80° flexion, MA TKA knees exhibited greater aPCL tension. Beyond 90° flexion, pPCL tension was higher in MA TKA knees. CONCLUSIONS: PCL tension was notably higher in MA TKA knees. However, FA TKA and MA TKA demonstrated comparable kinematics and changes in ACL force. Although FA TKA more closely restored the physiological balance of the cruciate ligaments, the overall effect appeared to be limited. LEVEL OF EVIDENCE: Level II.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Efficacy of functional alignment in total knee arthroplasty in restoring in vivo cruciate ligament forces and knee kinematics compared with mechanical alignment
- Date Crossref
- 27/10/2025
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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The University of Tokyo Department of Orthopaedic Surgery pays non établi dans la noticeUniversité ou école supérieure
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Saitama Medical University Department of Orthopaedic Surgery pays non établi dans la noticeUniversité ou école supérieure
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Tokyo Teishin Hospital Department of Orthopaedics pays non établi dans la noticeÉtablissement de santé
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Shonan Institute of Technology pays non établi dans la noticeUniversité ou école supérieure
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Scripps Research Institute Department of Molecular Medicine Arthritis Research pays non établi dans la noticeOrganisation à but non lucratif
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Morinomiya University of Medical Sciences Department of Health Sciences pays non établi dans la noticeUniversité ou école supérieure
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The University of Osaka pays non établi dans la noticeUniversité ou école supérieure
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Faculty of Medicine Department of Orthopaedic Surgery pays non établi dans la noticeUniversité ou école supérieure
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Department of Informatics Faculty of Informatics Department of Informatics pays non établi dans la noticeUniversité ou école supérieure
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Department of Orthopaedic Biomaterial Science Osaka University Graduate School of Medicine Osaka Japan Department of Orthopaedic Biomaterial Science pays non établi dans la noticeUniversité ou école supérieure
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Graduate School of Health Sciences Department of Health Sciences pays non établi dans la noticeUniversité ou école supérieure
Department of Orthopaedic Surgery — The University of Tokyo, Department of Orthopaedic Surgery — Saitama Medical University et Department of Orthopaedics — Tokyo Teishin Hospital, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.