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Related Experiment Video

Updated: Feb 27, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Optimizing Mechanical Alignment With Modular Stems in Revision TKA.

Andrew N Fleischman1, Ibrahim Azboy1, Camilo Restrepo1

  • 1The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.

The Journal of Arthroplasty
|June 27, 2017
PubMed
Summary
This summary is machine-generated.

Press-fit stems improve femoral alignment in revision total knee arthroplasty compared to modular stems. Optimal stem engagement with the diaphysis enhances accurate implant alignment for better function.

Keywords:
mechanical alignmentmodular stemsradiographsrevision total knee arthroplastystem fixation

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Implant design

Background:

  • Accurate mechanical alignment is crucial for total knee arthroplasty (TKA) success and implant longevity.
  • The influence of modular stems on achieving ideal femoral and tibial alignment in revision TKA remains incompletely understood.

Purpose of the Study:

  • To investigate the effectiveness of different stem fixation methods in achieving ideal alignment during revision total knee arthroplasty.
  • To compare the alignment outcomes associated with press-fit versus modular stems in revision TKA.

Main Methods:

  • A retrospective analysis of 319 revision TKAs performed between 2003 and 2013.
  • Prospective recording of stem length, diameter, and fixation method.
  • Radiographic measurement of three-dimensional canal-filling ratio and alignment in anteroposterior (AP) and lateral planes.

Main Results:

  • Ideal AP femoral alignment (95°) and lateral alignment (1-4° flexion/extension) were assessed.
  • Ideal tibial alignment in the AP plane was defined as 90°.
  • Press-fit stems demonstrated more reliable achievement of ideal AP femoral alignment, even when controlling for stem size and canal fill.

Conclusions:

  • Press-fit stems facilitate more consistent achievement of ideal femoral alignment in revision TKA.
  • Enhanced engagement between canal-filling stems and the diaphyseal axis promotes accurate implant alignment.