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Femoral component rotation in mobile-bearing total knee arthroplasty.
J G Boldt1, J B Stiehl, U Munzinger
1St Vinzenz Hospital, Dusseldorf, Germany.
The Knee
|April 25, 2006
Summary
This study found that the tibial cut first surgical method for mobile-bearing total knee arthroplasty (TKA) generally achieves optimal femoral component rotation. Most TKAs demonstrated alignment within functional ideals, ensuring satisfactory clinical outcomes.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- The LCS mobile-bearing total knee arthroplasty (TKA) has utilized a tibial cut first surgical technique since 1977.
- This method necessitates precise determination of femoral rotation using tension spacing.
Purpose of the Study:
- To evaluate the accuracy of femoral component rotation in mobile-bearing TKA using the tibial cut first method.
- To assess the relationship between femoral component alignment and clinical outcomes.
Main Methods:
- Retrospective review of 38 randomly selected mobile-bearing TKA cases.
- Spiral computed tomography (CT) scans to measure the posterior condylar angle (PCA).
- PCA was measured in relation to the surgical transepicondylar axis (TEA).
Main Results:
- The mean femoral component alignment was 0.3 degrees internal rotation relative to the TEA (SD=2.2°, range: 6° internal to 4° external).
- 90% of cases achieved PCA within 3° of the TEA, considered the functional ideal.
- One case (5° internal rotation) exhibited lateral patellar tilt and subluxation.
Conclusions:
- The tibial cut first technique for mobile-bearing TKA generally yields accurate femoral component rotation.
- Achieving alignment within 3° of the TEA is common and associated with satisfactory clinical results.
- Deviations in rotation may be linked to specific complications like patellar maltracking.