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Patient-specific and intra-operatively modifiable factors assessed by computer navigation predict maximal knee flexion one year after TKA

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

There are multiple factors affecting maximal knee flexion (MKF) after total knee arthroplasty (TKA). The aim of the study was to investigate whether patient-specific factors (PSF) and surgically modifiable factors (SMF), measured by means of a computer-assisted navigation system, can predict the MKF after TKA.

Methods

Data from 99 patients collected during a randomized clinical trial were used for this secondary data analysis. The MKF of the patients was measured preoperatively and 1-year post-surgery. Multiple regression analyses were performed to investigate which combination of variables would be the best to predict the 1-year MKF.

Results

When considering SMF alone, the combination of three factors significantly predicted the 1-year MKF (p = 0.001), explaining 22 % of its variation. When considering only PSF, the combination of pre-op MKF and BMI significantly predicted the 1-year MKF (p < 0.001), explaining 23 % of its variation. When considering both groups of potential predictors simultaneously, the combination of five SMF with two PSF significantly predicted the 1-year MKF (p = 0.001), explaining 32 % of its variation.

Conclusions

Computer navigation variables alone could explain 22 % of the variance in the 1-year MKF. The larger proportion (32 %) of the 1-year MKF variation could be explained with a combination of SMF and PSF. The results of studies in this area could be used to identify patients at risk of poor outcomes.

Level of Evidence

Level II, Prognostic study.

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Acknowledgments

The authors would like to thank Monika Hammond and Roy Hammond for proofreading the final version of the manuscript.

Author information

Authors and Affiliations

  1. Research Center of the Orthopedic and Joint Replacement Department, Schoen Klinik Hamburg Eilbek, Dehnhaide 120, 22081, Hamburg, Germany

    Frank Lampe & Carlos J. Marques

  2. Department of Orthopedics and Joint Replacement, Schoen Klinik Hamburg Eilbek, Dehnhaide 120, 22081, Hamburg, Germany

    Franziska Fiedler & Anusch Sufi-Siavach

  3. Faculty of Life Sciences, Hamburg University of Applied Sciences, Lohbrügger Kirchstraße 65, 21033, Hamburg, Germany

    Frank Lampe

  4. Mathematic Methods Department, Faculty of Human Kinetics, Lisbon University, Estrada da Costa, 1499-002, Cruz Quebrada, Portugal

    Ana I. Carita

  5. Orthopaedic Department, Jena University Hospital, Campus Eisenberg, Klosterlausnitzer Straße 81, 07607, Eisenberg, Germany

    Georg Matziolis

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  1. Frank Lampe
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  2. Carlos J. Marques
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Corresponding author

Correspondence to Carlos J. Marques.

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Conflict of interest statement

Prof. Dr. Lampe is a consultant for B. Braun Aesculap. B. Braun Aesculap is sponsoring the research position of Mr. Marques at the Science Office of the Department of Orthopedics and Joint Replacement. Ms. Fiedler, Dr. Sufi-Siavach, Prof. Dr. Carita and Prof. Dr. Matziolis have no financial relationships to disclose.

Ethical review committee statement

The Medical Ethics Commission of the Federal State of Hamburg approved the research proposal (File Number: #2226). The clinical trial was registered under ClinicalTrials.gov (NCT00822640).

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Lampe, F., Marques, C.J., Fiedler, F. et al. Patient-specific and intra-operatively modifiable factors assessed by computer navigation predict maximal knee flexion one year after TKA. Knee Surg Sports Traumatol Arthrosc 24, 3457–3465 (2016). https://doi.org/10.1007/s00167-016-4134-x

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