Comparison of in vivo knee kinematics before and after bicruciate-stabilized total knee arthroplasty during squatting

Abstract

Background: No studies have directly evaluated kinematic changes during squatting before and after bicruciate-stabilized total knee arthroplasty (BCS-TKA) with the dual cam-post mechanism and asymmetric surfaces. This study investigated the effect of BCS-TKA on changes to pre- and postoperative skeletal knee kinematics, to identify factors associated with postoperative skeletal kinematic parameters. Methods: Seventeen knees in 17 patients were prospectively recruited before primary TKA for advanced medial knee osteoarthritis. Subjects underwent BCS-TKA and were evaluated more than 1 year postoperatively. In vivo dynamic skeletal knee kinematics were evaluated using periodic radiographic images collected during squatting to quantify the tibiofemoral functional extension/flexion angle, anteroposterior (AP) translation, and axial rotation angle using image-matching techniques. Rotational alignments of femoral and tibial components were measured postoperatively using computed tomography images. Results: The pre- and postoperative tibiofemoral functional extension/flexion angles during squatting were 12.2° ± 6.7°/100.1° ± 16.8° and 9.6° ± 8.6°/109.4° ± 16.8°, respectively, with a significant difference in flexion angle (p