We aimed to retrospectively investigate the morphology of the resected surfaces of femurs in Chinese patients who underwent total knee arthroplasty (TKA) and to assess the suitability of contemporary femoral components. Measurements on three-dimensional reconstruction after virtual bone cutting were performed on 142 knees from Chinese TKA candidates. The anteroposterior (AP) and mediolateral (ML) dimensions, aspect ratio (ML/AP), and posterior condylar angle (PCA) were measured in the axial plane; the height and length of medial and lateral anterior condyles and the maximal width of the anterior condyles were measured in the frontal plane. Femurs were matched to the prosthesis with the closest AP size. The ML dimensions of femurs were compared with the ML dimensions of the prosthesis. The AP and ML dimensions were significantly larger in male knees ( < 0.01), whereas the difference of aspect ratios was not found to be significantly different between genders ( = 0.26). Both medial and lateral heights of the anterior condyles were significantly higher in men after normalization by AP ( < 0.01 and < 0.05, respectively). The mean PCA averaged 3.8 degrees for Chinese subjects. The overall prevalence of clinically significant overhang was 6.4% in males and 4.8% in females. The design of femoral prosthesis with alternative ML dimensions of the femoral component is a solution to sufficiently avoid overhang while retaining ideal coverage when dealing with a high variation. Chinese men had higher anterior condyles than women after normalization by AP dimension. The mean PCA was 3.8 degrees for all patients with high variability.
ObjectiveArtificial hip dislocation is one of the most serious complications following
total hip replacement. This study was performed to assess articular capsule
repair in primary total hip replacement with the anterolateral approach
(Watson-Jones incision) and its effect on postoperative dislocation.MethodsPatients who underwent primary total hip replacement by the anterolateral
approach in Tongren Hospital of Shanghai Jiao Tong University School of
Medicine from June 2007 to June 2014 were retrospectively analyzed. The
patients were divided into the repair and dissection groups based on the
articular capsule repair status during surgery. Postoperative dislocation
rates were compared between the two groups using the chi-squared test.ResultsThe repair and dissection groups comprised 137 and 248 patients,
respectively. All patients were followed up for 6 months to 5 years
(average, 3.75 years). The mean age, sex, disease composition, and follow-up
time were not significantly different between the two groups. Early
postoperative dislocation occurred in 1 hip (0.7%) in the repair group and
13 hips (5.2%) in the dissection group.ConclusionsDuring the anterolateral approach for primary total hip replacement,
articular capsule repair may reduce the occurrence of early postoperative
dislocation of the hip joint.
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