The Effects of Axial Rotational Alignment of the Femoral Component on Knee Stability and Patellar Tracking in Total Knee Arthroplasty Demonstrated on Autopsy Specimens

Anouchi, Yoel S.; Whiteside, Leo A.; Kaiser, Aric D.; Milliano, Michael T.

doi:10.1097/00003086-199302000-00027

Cited by 310 publications

(232 citation statements)

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“…O alinhamento rotacional femoral afeta a excursão patelar, os pontos de contato e as pressões femoropatelares (3)(4)(5)(6)(7) , porém pouca informação existe a respeito da sua relação com o componente patelar (8) . Pacientes com rotação externa dos componentes entre 0 e 10 o não apresentaram complicações femoropatelares.…”

Section: Discussionunclassified

“…Pacientes com rotação externa dos componentes entre 0 e 10 o não apresentaram complicações femoropatelares. Anouchi et al, em estudo em cadáveres, e Whiteside et al, em pacientes, mostraram que o alinhamento do componente femoral em rotação interna, além das complicações patelares, pode causar ainda instabilidade do joelho em flexão (3)(4) . Essa instabilidade ocorre pela diferença de tamanho entre as brechas em extensão e flexão causada pela alteração das dimensões relativas dos côndilos posteriores em flexão.…”

Section: Discussionunclassified

“…É possível que os eixos definidos nesse estudo estejam em rotação externa em relação ao eixo transepicondilar verdadeiro, fato já observado em outros estudos pela tendência dos cirurgiões em errar no sentido de aumentar a rotação externa, procedimento conhecido e utilizado para evitar os resultados indesejáveis relacionados à rotação interna (3,9) . Entretanto, a rotação externa excessiva também pode trazer problemas, como aumento das forças de cisalhamento no componente patelar e instabilidade em flexão devido ao aumento da brecha medial em flexão (9) .…”

Section: Discussionunclassified

“…O alinhamento rotacional inadequado do componente femoral na artroplastia total do joelho afeta a estabilidade mediolateral em flexão e o trajeto da patela no seu encaixe sobre a tróclea (1)(2)(3) .…”

Section: Introductionunclassified

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Alinhamento rotacional do componente femoral na artroplastia total do joelho

Júnior¹,

Gonçalves²,

Soares³

et al. 2007

Rev. bras. ortop.

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Section: Discussionunclassified

Section: Introductionunclassified

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Alinhamento rotacional do componente femoral na artroplastia total do joelho

Júnior¹,

Gonçalves²,

Soares³

et al. 2007

Rev. bras. ortop.

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“…In addition, the femoral and tibial components must be placed in the appropriate position to minimize issues with the patellofemoral joint. Components that are inappropriately medial may contribute to patellar maltracking and subsequent failures [15][16][17][18][19]. Similarly, components that are malaligned in the coronal or sagittal plane will contribute to failures of the patellofemoral joint.…”

Section: Influence Of Tibiofemoral Jointmentioning

confidence: 99%

The patella in total knee arthroplasty: to resurface or not is the question

Abdel

Parratte

Budhiparama³

2014

Curr Rev Musculoskelet Med

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The decision to resurface the patella during total knee arthroplasty remains controversial. Even though some surgeons routinely resurface the patella to avoid the increased rates of postoperative anterior knee pain and reoperation for secondary resurfacing, others selectively resurface based on the presence of anterior knee pain, notably damaged articular cartilage, inflammatory arthritis, isolated patellofemoral arthritis, and patellar subluxation and maltracking. The anatomy and biomechanics of the patellofemoral joint, combined with advances in surgical technique and prostheses must be taken into account when making a decision to resurface the patella. Accurate component implantation is imperative for a successful outcome if the patella is resurfaced.

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Femoral rotational asymmetry is a common anatomical variant

2018

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The sulcus line (SL) is a three-dimensional landmark that corrects for individual variation in the coronal alignment of the trochlear groove in contrast to the traditional Whiteside's line (WL). Femoral rotational asymmetry (FRA) is an anatomical variation in which the posterior condyles and trochlear groove are not perpendicular to each other. This study aims to measure the SL and assess its reliability relative to WL, in addition to measuring and classifying the FRA. A retrospective analysis of a series of 191 CT scans of nonarthritic knees was performed. Measurements were taken of rotational landmarks in three-dimensional reconstructions. The variability and outlier rate of SL was less than WL (P < 0.05), however, it was also greater than the posterior condylar line (PC) (P < 0.05). Averaging the PC + 3° and the SL did not change the rate of femoral malrotation relative to the surgical epicondylar axis (SEA) (P > 0.05), however it decreased the rate of change of the rotational alignment of the trochlear groove between the native knee and the prosthetic knee from 31% to 5% (P < 0.05). FRA was classified and was >5° in 56/191 (29%) of cases. The SL technique is more accurate than WL for determining the rotational alignment of the trochlear groove. Nonarthritic femora have a high rate of rotational asymmetry. Identifying and classifying FRA in individual cases allows the femoral component to be inserted in a position which gives the best possible match to both the native posterior condyles and trochlear groove. Clin. Anat. 31:551-559, 2018. © 2018 Wiley Periodicals, Inc.

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The Effects of Axial Rotational Alignment of the Femoral Component on Knee Stability and Patellar Tracking in Total Knee Arthroplasty Demonstrated on Autopsy Specimens

Cited by 310 publications

References 0 publications

Alinhamento rotacional do componente femoral na artroplastia total do joelho

Alinhamento rotacional do componente femoral na artroplastia total do joelho

The patella in total knee arthroplasty: to resurface or not is the question

Femoral rotational asymmetry is a common anatomical variant

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