Association between Kinematic Patterns and Patient-Reported Outcome Measures in Revision Total Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Knee Biomechanics

Background:

• Understanding knee kinematics in revision total knee arthroplasty (rTKA) is crucial due to altered soft tissue conditions.
• Limited data exists on the relationship between kinematics and patient outcomes in rTKA compared to primary TKA.

Purpose of the Study:

• To investigate the association between specific kinematic parameters (anteroposterior translation, post-cam engagement) and patient-reported outcome measures (PROMs) in rTKA patients.
• To compare kinematic differences between patients with higher and lower PROMs following rTKA.

Main Methods:

• Fluoroscopic assessment of tibiofemoral kinematics (femoral AP translation) during open-chain flexion-extension (FE) and closed-chain exercises (sit-to-stand, lunge) in 30 rTKA patients.
• Comparison of AP translation and post-cam engagement between two clusters defined by higher and lower PROMs at minimum six-month follow-up.

Main Results:

• The low-PROMs group showed a significantly more anterior femoral position in the medial compartment during mid-flexion in both STS and FE exercises compared to the high-PROMs group.
• No significant differences in AP translation were observed in the lateral compartment between the groups.
• Post-cam engagement did not differ significantly between the high- and low-PROM groups during any assessed exercises.

Conclusions:

• A more anterior femoral position in the medial compartment during mid-flexion is associated with poorer PROMs in rTKA patients.
• Kinematic variations, particularly medial compartment translation, may play a role in functional outcomes after rTKA.
• Further research is warranted to elucidate the complex relationship between knee kinematics and PROMs in the rTKA population.