Assessment of average femoral component rotation for balancing functionally aligned total knee replacement in varus deformity: Robotic image guidance study.

Autor: Murugesan HK; Department of Orthopaedics, Rex Ortho Hospital, Coimbatore, Tamil Nadu, India., Amudhaganesh S; Department of Orthopaedics, Rex Ortho Hospital, Coimbatore, Tamil Nadu, India., Chandrabose R; Department of Orthopaedics, Rex Ortho Hospital, Coimbatore, Tamil Nadu, India., Rudraraju RT; Department of Orthopaedics, Apollo Hospitals, Hyderabad, Telangana, India.; Department of Orthopaedics, SVS Medical College, Mahbubnagar, Telangana, India., Vijayanand S; Department of Orthopaedics, Rex Ortho Hospital, Coimbatore, Tamil Nadu, India.
Jazyk: angličtina
Zdroj: Journal of orthopaedics [J Orthop] 2024 Jun 01; Vol. 57, pp. 23-28. Date of Electronic Publication: 2024 Jun 01 (Print Publication: 2024).
DOI: 10.1016/j.jor.2024.05.027
Abstrakt: Introduction and Purpose: Ensuring proper femoral component alignment post-Total Knee Arthroplasty (TKA) is crucial for normal patellofemoral (PF) kinematics. However, the customary 3° external rotation relative to the Posterior Condylar Axis (PC Axis) may not universally apply, and the expected final femoral component rotation remains unclear in functionally aligned knees. This study examines the relation between the Transepicondylar Axis (TEA) and PC axis, known as Posterior Condylar Angle (PCA) in Indian patients along with factors influencing PCA, and the feasibility of reproducing patient-specific PCA using image-guided Cuvis joint robot.
Methods: Forty patients (52 Knees) with primary osteoarthritis and varus deformity were prospectively evaluated. Native PCA was determined using CT-based J planner. Pre-operative patellar shape, PF tilt, PF shift, final femoral component rotation (representing post-operative PCA), final patellar tracking, and post-operative functional and radiological assessment at 3 months were recorded.
Results: Study participants averaged 64.3 years of age, with a female-to-male ratio of 23 to 17. Varus deformities varied, with IA2 being most prevalent, and sagittal plane deformities included fixed flexion (34.6 %) and hyperextension (44.2 %). The average PCA was 1.9° (range: 0°-7.3°), with most knees (41 out of 52) below 3°. The majority had Wiberg type 1 patellae, with pre-operative patellar tilt averaging 5.63°, reducing post-operatively to 4.43°. Most patients (37 out of 40) achieved excellent Knee Society functional scores at the 3-month mark. Complications included one case of delayed wound healing and one femoral array pin breakage. Notably, our study revealed a significant deviation in PCA from the commonly reported 3° in Western literature, underscoring the need for region-specific considerations in TKA planning.
Conclusion: PCA of our population is statistically different from customary 3° followed with jig system. Image guided Robotics helps to identify patients specific PCA and reproducing the same was more commonly possible in patients with reducible Varus deformity.
Competing Interests: None.The authors declare that the research was conducted in the absence of any commercial or financial ties that could be construed as a potential conflict of interest. Hence, there are no conflicts of interest to disclose.
(© 2024 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)
Databáze: MEDLINE
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