ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016
Changes in the orientation of knee functional flexion axis during passive flexion and extension movements in navigated total knee arthroplasty.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- A new parameter in the era of robotic total knee arthroplasty: Coronal alignment at 90° of flexion impacts clinical outcomes.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Three-dimensional color map: a novel tool to locate the surgical transepicondylar axis.Annals of translational medicine · 2020Article
- Dynamic knee behaviour: does the knee deformity change as it is flexed-an assessment and classification with computer navigation.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2016Article
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Authors and funding
7 authors.
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Abstract
purposeRecently, the functional flexion axis has been considered to provide a proper rotational alignment of the femoral component in total knee arthroplasty. Several factors could influence the identification of the functional flexion axis. The purpose of this study was to analyse the estimation of the functional flexion axis by separately focusing on passive flexion and extension movements and specifically assessing its orientation compared to the transepicondylar axis, in both the axial plane and the frontal plane.
methodsAnatomical and kinematic acquisitions were performed using a commercial navigation system on 79 patients undergoing total knee arthroplasty with cruciate substituting prosthesis design. The functional flexion axis was estimated from passive movements, between 0° and 120° of flexion and back. Intra-observer agreement and reliability, internal-external rotation and the angle with the surgical transepicondylar axis, in axial and frontal planes, were separately analysed for flexion and extension, in pre- and post-implant conditions.
resultsThe analysis of reliability and agreement showed good results. The identification of the functional flexion axis showed statistically significant differences both in relation to flexion and extension and to pre- and post-implant conditions, both in frontal plane and in axial plane. The analysis of internal-external rotation confirmed these differences in kinematics (p < 0.05, between 25° and 35° of flexion).
conclusionsThe identification of the functional flexion axis changed in relation to passive flexion and extension movements, above all in frontal plane, while it resulted more stable and reliable in axial plane. These findings supported the possible clinical application of the functional flexion axis in the surgical practice by implementing navigated procedures. However, further analyses are required to better understand the factors affecting the identification of the functional flexion axis. LEVEL OF EVIDENCE: IV.
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