Accuracy of femoral rotational alignment in total knee arthroplasty using computer assisted navigation

Computer Aided Surgery : Official Journal of the International Society for Computer Aided Surgery
Camilo RestrepoJavad Parvizi

Abstract

Proper rotational alignment of components is crucial for the success of total knee arthroplasty (TKA). The traditional reference guides for assessment of femoral rotation include the posterior condylar axis, the anteroposterior axis, also known as Whiteside's line, and the transepicondylar axis (TEA). The fixed-angle posterior referencing system recommends that the rotational femoral cut be made at 3 degrees of external rotation. In a consecutive series of 100 patients undergoing TKA at our institution, the accuracy of these reference guides in determining the rotation of the femoral component was compared with that of a computerized navigation system. Although differences between the three reference methods were not statistically significant, the possibility of finding an outlier leading to excessive external or internal rotation of the femoral component when using a fixed posterior condyle reference guide mandates the use of other referencing methods to avoid this error. Using fixed posterior referencing, up to 17% of femoral components would have differed by more than 5 degrees from the anatomic reference landmarks (TEA, Whiteside's line). This degree of rotational malalignment could lead to knee instability and early failure.

References

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Citations

Sep 16, 2011·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Jai-Gon SeoSang-Min Kim
May 18, 2011·The Journal of Arthroplasty·John B MedingRobert A Malinzak
Mar 27, 2013·Clinical Biomechanics·Stephen J IncavoPhilip C Noble
Nov 12, 2016·The Journal of International Medical Research·Daniel Hernández-VaqueroJose Manuel Fernandez-Carreira
Feb 11, 2012·The Journal of Bone and Joint Surgery. British Volume·H-E HoffartN Vasak
Sep 6, 2012·Clinical Orthopaedics and Related Research·R Stephen J Burnett, Robert L Barrack

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