Evidence map›Paper›PMID 32239272›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021

A cruciate-retaining implant can treat both knees of most windswept deformities when performed with calipered kinematically aligned TKA.

Stephen M Howell, Trevor J Shelton, Manpreet Gill, Maury L Hull

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Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed.

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  16. Reoperations are few and confined to the most valgus phenotypes 4 years after unrestricted calipered kinematically aligned TKA.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Stephen M HowellDepartment of Biomedical Engineering, University of California, Davis, 451 E. Health Sciences Drive, Room 2303, Davis, CA, 95616, USA.
Trevor J SheltonDepartment of Orthopaedic Surgery, University of California, Davis, 4860 Y Street, Suite 3800, Sacramento, CA, 95817, USA. tjshelton@ucdavis.edu.
Manpreet GillAdventist Health Lodi Memorial Hospital, 975 S. Fairmont Ave., Lodi, CA, 95240, USA.
Maury L HullDepartment of Biomedical Engineering, University of California, Davis, 451 E. Health Sciences Drive, Room 2303, Davis, CA, 95616, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgeons performing total knee arthroplasty (TKA) on the osteoarthritic valgus deformity often use a posterior stabilized (PS) and semi-constrained implants to substitute for the release of a contracted posterior cruciate ligament (PCL) instead of a cruciate retaining (CR) implant. Calipered kinematic alignment (KA) strives to retain the PCL and use a CR implant. The aim of this study of the windswept deformity was to determine whether the level of implant constraint, outcome scores, and alignment after bilateral calipered KA TKA are different between a pair of knees with a varus and valgus deformity in the same patient.

methodsA review of a prospectively collected database identified all patients with a windswept deformity treated with bilateral TKA (n = 19) out of 2430 consecutive primary TKAs performed between 2014 and 2019. Operative reports determined the level of implant constraint. Patient response to the Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) assessed outcomes at a mean follow-up of 2.3 years. Postoperative alignment was measured on an A-P computer tomographic scanogram of the limb.

resultsCR implants were used in 15 of 19 (79%) valgus deformities and 17 of 19 (89%) of varus deformities (n.s.). No knees required a semi-constrained implant. There was no difference in the median postoperative FJS and OKS (n.s.), and a 1° or less difference in the mean postoperative distal lateral femoral angle (p = 0.005) and proximal medial tibial angle (n.s.) between the paired varus and valgus knee deformity.

conclusionBased on this small series, surgeons that use calipered KA TKA can expect to use CR implants in most patients with windswept deformity and achieve comparable outcome scores and alignment between the paired varus and valgus deformity. LEVEL OF EVIDENCE: IV.

Indexed as

Knee ProsthesisAgedArthroplasty, Replacement, KneeBiomechanical PhenomenaExternal FixatorsFemaleFemurHumansKneeKnee JointMaleMiddle AgedOsteoarthritis, KneePostoperative PeriodRange of Motion, ArticularRetrospective StudiesForgotten knee scoreKinematic alignmentKnee arthroplastyOxford knee scoreWindswept deformity

Identifiers

PMID32239272

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.