Femoral component rotation in patients with leg axis deviation

Abstract

This study suggests that it is possible to achieve correct rotational alignment of the femoral component and a symmetrical flexion gap using the tibial-cut-first technique in patients with a preoperatively deviated leg axis.

Rotational alignment of the distal femur: anthropometric measurements with CT-based patient-specific instruments planning show high variability of the posterior condylar angle

“…A final limitation of this study is that neither via the CT nor via the PSI preoperative planning, information on the soft tissues or ligament balancing was available. The planning is a measured resection technique, and since these patients were not evaluated during surgery and we had no access to surgical reports, no information was available about the gap balancing [11, 19, 20].…”

Significance of asymmetrical posteromedial and posterolateral femoral condylar chamfer cuts in total knee arthroplasty

“…Proper femoral component rotation is critical for the success of current knee prosthesis designs [6][7][8][9][10][16][17][18][19][20][21][22][23][24][25]. The TEA has been shown to approximate the flexionextension axis of the knee and run perpendicular to the mechanical axis with the knee flexed at 90° [25].…”

“…Excessive external rotation, on the other hand, can disrupt the extensor mechanism, creating tightness in the lateral side in flexion, but creating relative laxity on the medial side, which leads to medial liftoff [13,18,21,27]. In either situation, the clinical consequences manifest as patella femoral instability, anterior knee pain, arthrofibrosis, and flexion instability [3,6,7,[15][16][17][18][19].…”

The effect of tibio-femoral over-distraction in primary knee arthroplasty

“…For example, when between component sizes, especially in regards to the tibial insert, using a thinner tibial insert may be beneficial. Unfortunately due to the variability of anatomical landmarks, especially between varus and valgus knees, it is difficult to ascertain intra‐operative landmarks to help prevent over‐distraction [7, 12].…”