Averaging rotational landmarks during total knee arthroplasty reduces component malrotation caused by femoral asymmetry

Journal of Orthopaedic Surgery and Research
Tat Woon ChaoSimon Talbot

Abstract

Femoral component malrotation is a common cause of patient dissatisfaction after total knee arthroplasty. The sulcus line (SL) is more accurate than Whiteside's line as it corrects for variation in the coronal orientation of the groove. The hypothesis is that averaging the SL and posterior condylar axis (PCA) will reduce femoral malrotation. The component was inserted at a position between the SL and PCA in 91 patients. An intraoperative photograph was taken showing the landmarks. These were compared to the component position achieved relative to the surgical epicondylar axis (SEA) on a postoperative CT scan. The component position was compared to the position achieved using the individual landmarks. Relative to the SEA, the final component position was 0.6° (SD 1.4°, range -3.8° to +4.0°), the coronally corrected SL position was -0.7° (SD 2.3°, -5.5° to +4.6°), the PCA position was 0.9° (SD 1.9°, -6.1° to +5.0°). Averaging the landmarks significantly decreased the variance of the component position compared to using the SL and PCA individually. The number of outliers (>3° from SEA) was also significantly less (p < 0.05) for the average position (2/84) when each was compared to the SL (16/84) and PCA (14/84) individually. In 21...Continue Reading

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Citations

Jan 24, 2018·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Christopher R NewmanSimon Talbot
May 1, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Paweł SkowronekUNKNOWN European Knee Associates (EKA)

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