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A lateral retinacular release during total knee arthroplasty changes femorotibial kinematics: an in vitro study

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Lateral retinacular release (LRR) is a common procedure during total knee arthroplasty (TKA), especially if patellar maltracking is observed intraoperatively. The impact of LRR on patellofemoral kinematics is well-examined, but the influence on femorotibial kinematics requires more elucidation. Therefore, the aim of this study was to evaluate the effects of LRR on femorotibial kinematics in vitro.

Materials and methods

A fixed bearing TKA was implanted in six human knee specimens. Femorotibial kinematics were measured dynamically through the use of a custom-constructed knee rig which flexes the knee from 20° to 120° under weight bearing conditions. Measurements were performed before and after LRR. LRR was performed completely including transection of synovium, retinaculum and tractus fibers. For the registration of tibiofemoral kinematics a 3-dimensional-ultrasound-based motion analysis system was used.

Results

LRR revealed a significant reduction of femoral rollback at the lateral compartment (9.4 ± 5.0 vs 7.8 ± 9.4 mm; p < 0.01), whereas the present decrease of femoral rollback at the medial compartment was not significant (3.4 ± 4.7 vs 2.3 ± 5.9 mm; p = 0.34). Accordingly, LRR significantly reduced internal rotation of the tibia (0.8°; p < 0.01).

Conclusion

The results suggest that LRR significantly decreases lateral femoral rollback as well as internal rotation of the tibia, probably by changing the tension of the iliotibial band. When performing a LRR in clinical routine, surgeons should be aware of altering not only patellofemoral kinematics but also the femorotibial kinematics.

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Acknowledgements

We thank the Aesculap B.Braun company for donating the prostheses used in this study.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Campus Grosshadern, Marchioninistr. 15, 81377, Munich, Germany

    Arnd Steinbrück, Christian Schröder, Matthias Woiczinski, Alexander Glogaza, Peter E. Müller, Volkmar Jansson & Andreas Fottner

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  1. Arnd Steinbrück
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Correspondence to Arnd Steinbrück.

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Conflict of interest

On behalf of all authors, the corresponding author is stating the following conflicts of interest: Aesculap B.Braun has donated the prostheses used in this study. They had no influence on the study design nor on the results or interpretation of data. Furthermore they had no involvement in writing the manuscript and no influence in the decision to submit the article in this journal. Besides this study following potential conflicts may exist: Arnd Steinbrück has received funding from B.Braun Aesculap, Medacta International, Implantcast. Christian Schröder—no conflict of interest; Matthias Woiczinski—no conflict of interest; Alexander Glogaza—no conflict of interest; Peter E. Müller has received funding from B.Braun Aesculap, Exatech, Medacta International and Orthospace; he is member of the editorial board of Archives of Medical Science; Volkmar Jansson has received funding from B.Braun Aesculap, Medacta International; Andreas Fottner—no conflict of interest.

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Steinbrück, A., Schröder, C., Woiczinski, M. et al. A lateral retinacular release during total knee arthroplasty changes femorotibial kinematics: an in vitro study. Arch Orthop Trauma Surg 138, 401–407 (2018). https://doi.org/10.1007/s00402-017-2843-3

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