Flexion Space Balancing Through Component Positioning and Its Relationship to Traditional Anatomic Rotational Landmarks in Robotic Total Knee Arthroplasty
| Autor: | Trevor M. Staub, Sridhar R. Rachala, Scott R. Nodzo, K. Keely Boyle, Jeffrey M. Jancuska, Michael D. Cobler-Lichter |
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| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
Knee Joint Rotation Radiography Total knee arthroplasty Condyle 03 medical and health sciences 0302 clinical medicine Robotic Surgical Procedures Humans Medicine Orthopedics and Sports Medicine Femur Range of Motion Articular Femoral component Arthroplasty Replacement Knee Balance (ability) Orthodontics 030222 orthopedics biology business.industry Medial femoral condyle Osteoarthritis Knee musculoskeletal system biology.organism_classification body regions Valgus Component (group theory) business |
| Zdroj: | The Journal of Arthroplasty. 35:1569-1575 |
| ISSN: | 0883-5403 |
| DOI: | 10.1016/j.arth.2020.01.051 |
| Popis: | Background The use of the femoral component position to balance the flexion space and its relationship to the transepicondylar axis (TEA) and posterior condylar angle (PCA) has not been thoroughly evaluated. Methods A total of 233 patients undergoing robotic arm–assisted total knee arthroplasty were evaluated. Native TEA and PCA were established on preoperative computed tomography scans. Femoral component rotation was set in the axial plane to match the native trochlea and native medial femoral condyle to set the flexion gap. Knee flexion space gaps and component position were recorded. The relationship of the femoral component to the native TEA, PCA, and preoperative radiographic landmarks was evaluated. Results The intraoperative measured medial flexion space gap did not significantly correlate with the relationship of the femoral component to the PCA or TEA in varus or valgus knees. In varus knees, the preoperative mechanical axis alignment had a positive relationship to femoral component position when compared to the PCA (P = .04) and TEA (P = .002). In valgus knees, there was a positive correlation between the preoperative lateral distal femoral angle and component position when compared to the PCA (P = .04) only. Conclusion Intraoperative measured flexion space balance through femoral component positioning did not correlate with its relationship to the native TEA or PCA. In varus knees, the preoperative mechanical axis alignment correlated with an increase in femoral component external rotation to the TEA and PCA. In valgus knees, the severity of preoperative lateral distal femoral angle correlated with the rotational relationship of the femoral component to the PCA only. |
| Databáze: | OpenAIRE |
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