Decreasing Posterior Femoral Condyle Offset Improves Intraoperative Correction of Flexion Contracture in Total Knee Arthroplasty
| Autor: | Myles Coolican, Antonio Klasan, Murilo Anderson Leie, Wei Wang Yeo, Dylan Misso |
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| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Contracture Offset (computer science) Knee Joint Total knee arthroplasty Osteoarthritis Condyle 03 medical and health sciences 0302 clinical medicine Humans Medicine Orthopedics and Sports Medicine Femur Range of Motion Articular Arthroplasty Replacement Knee Flexion contracture 030222 orthopedics business.industry FEMORAL CONDYLE 030229 sport sciences Osteoarthritis Knee musculoskeletal system medicine.disease Surgery Implant Knee Prosthesis business |
| Zdroj: | The Journal of Knee Surgery. 35:653-660 |
| ISSN: | 1938-2480 1538-8506 |
| DOI: | 10.1055/s-0040-1716415 |
| Popis: | Multiple intraoperative strategies are described to achieve full extension in total knee arthroplasty, but only a few studies have assessed the effect of the flexion gap on intraoperative improvement in flexion contracture. The aim of this study was to determine whether posterior condylar offset, in isolation, independently affects extension at the time of total knee arthroplasty.Two hundred and seventy-eight patients who underwent total knee arthroplasty for knee osteoarthritis and flexion contracture ≥ 5 degrees between January 2008 and July 2018 were included in this study. Patients with other factors that could affect knee extension at the time of surgery were excluded. We recorded the thickness of posterior femoral condyle bone resected as well as the thickness of the posterior femoral component chosen for each patient. Patients' knee extension was recorded under anesthetic, prior to resection and intraoperatively after total knee replacement.Average thickness of bone resection for the posteromedial femur was 12.64 ± 1.65 mm and for the posterolateral femur was 10.38 ± 1.52 mm. Using a linear regression model, we found that changes in posterior offset and implant downsizing influenced correction of fixed flexion deformity at the time of surgery. When patients had a combined posteromedial and posterolateral offset 2 mm thinner than the thickness of bone resected, there was an average correction of 3.5 degrees of flexion contracture.Our study demonstrated that posterior femoral condyle offset is an independent variable affecting correction of flexion contracture at the time of surgery in a gap balanced cruciate-retaining total knee arthroplasty. This is a level IV evidence study. |
| Databáze: | OpenAIRE |
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