Femoral rotation in total knee arthroplasty: a comparison of patient individualized jigs with gap balancing in relation to anatomic landmarks.

Autor: Fitz W; Department of Orthopaedic Surgery, Brigham and Women's and Brigham Faulkner Hospital, 850 Boylston Street, Chestnut Hill, MA, 02467, USA., Jäger S; Laboratory of Biomechanics and Implant Research, Department of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstr. 200A, 69118, Heidelberg, Germany., Rieger JS; Laboratory of Biomechanics and Implant Research, Department of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstr. 200A, 69118, Heidelberg, Germany., Seebach E; Research Centre for Experimental Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstr. 200A, 69118, Heidelberg, Germany., Bitsch RG; Laboratory of Biomechanics and Implant Research, Department of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstr. 200A, 69118, Heidelberg, Germany. Rudi_Georg.Bitsch@urz.uni-heidelberg.de.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2017 Jun; Vol. 25 (6), pp. 1712-1719. Date of Electronic Publication: 2015 Oct 24.
DOI: 10.1007/s00167-015-3836-9
Abstrakt: Purpose: The purpose of our study was to compare the accuracy of the rotational position of the femoral component in total knee arthroplasty aligned with patient individualized jigs (PSJ) to a gap balancing technique (GBT).
Methods: A consecutive series of 21 osteoarthritic patients were treated with 22 cruciate-retaining total knee prostheses. During surgery, the rotation of the femoral component pinholes was recorded for all knees using PSJ and GBT and transferred to computer tomograms (CT). The rotational differences between PSJ and GBT relative to the transepicondylar axis were analysed.
Results: The medium rotation of the femoral component pinholes was 1.3° ± 5.1° (min = -6.3°; max = 14.4°) for PSJ and 0.1 ± 1.4° (min = -1.6°; max = 3.4°) for GBT. Outliers of more than 3° were found more frequently with PSJ in 12 cases but only in one for GBT.
Conclusion: Based on our study, we would not recommend relying intra-operatively solely on the CT-based PSJ without the option to adjust or control femoral rotation.
Level of Evidence: II.
Databáze: MEDLINE
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