The Influence of Femoral Internal Rotation on Patellar Tracking in Total Knee Arthroplasty Using Gap Technique

Ko, Dong Oh; Lee, Song; Kim, Jin Hak; Hwang, Il Chan; Jang, Sung Jun; Jung, Jin Hwa

doi:10.4055/cios20168

Cited by 10 publications

(7 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many landmarks are described with no evidence to date regarding the best methods. This topic, still unresolved, can be considered another cornerstone for a successful TKA [ 41 ]. Similarly, sagittal alignment of both femoral and tibial components can influence the flexion space, the postoperative range of motion, and thus patients’ satisfaction [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Coronal alignment in total knee arthroplasty: a review

Matassi,

Pettinari,

Frasconà

et al. 2023

J Orthop Traumatol

View full text Add to dashboard Cite

Total knee arthroplasty (TKA) alignment has recently become a hot topic in the orthopedics arthroplasty literature. Coronal plane alignment especially has gained increasing attention since it is considered a cornerstone for improved clinical outcomes. Various alignment techniques have been described, but none proved to be optimal and there is a lack of general consensus on which alignment provides best results. The aim of this narrative review is to describe the different types of coronal alignments in TKA, correctly defining the main principles and terms.

show abstract

Section: Discussionmentioning

confidence: 99%

Coronal alignment in total knee arthroplasty: a review

Matassi,

Pettinari,

Frasconà

et al. 2023

J Orthop Traumatol

View full text Add to dashboard Cite

show abstract

“…Although total knee arthroplasty (TKA) is associated with excellent surgical outcomes and longevity for decades 1,2 , aseptic loosening of the tibial component is the most common cause of late failure in TKA and is a major cause of revision TKA [3][4][5] . Various factors, including patient activities, malalignment, obesity, and poor bone quality, contribute to aseptic loosening of the tibial component [5][6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Effects of Stem Extension of Tibial Components for Medial Tibial Bone Defects in Total Knee Arthroplasty: A Finite Element Study

Park,

Kang,

Kwon

et al. 2024

J Knee Surg

View full text Add to dashboard Cite

The aim of this study was to investigate the biomechanical effects of stem extension with a medial tibial bone defect in primary total knee arthroplasty (TKA) on load distribution and stress in the proximal tibia using finite element (FE) analysis.FE simulations were performed on the tibia bone to evaluate the stress and strain on the tibia bone and bone cement. This was done to investigate the stress shielding effect, stability of the tibia plate, and the biomechanical effects in TKA models with various medial defects and different stem length models.The results demonstrated that in the bone defect model, the longer the stem, the lower the average von Mises stress on the cortical and trabecular bones. In particular, as the bone defect increased, the average von Mises stress on cortical and trabecular bones increased. The average increase in stress according to the size of the bone defect was smaller in the long stem than in the short stem. The maximal principal strain on the trabecular bone occurred mainly at the contact point on the distal end of the stem of the tibial implant. When a short stem was applied, the maximal principal strain on the trabecular bone was approximately 8% and 20% smaller than when a long stem was applied or when no stem was applied, respectively.The findings suggest that a short stem extension of the tibial component could help achieve excellent biomechanical results when performing TKA with a medial tibial bone defect.

show abstract

“…The rotational alignment of the femoral component in total knee arthroplasty (TKA) has been reported to be an important factor in patellofemoral and tibiofemoral knee kinematics [1][2][3][4][5]. Excessive internal rotation of the femoral component with respect to the femoral posterior condylar axis (PCA) can lead to knee pain and stiffness, which 2 of 10 negatively affects clinical outcomes [2,[6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“Boot Sign” of Anterior Femoral Condylar Resectional Shape during Total Knee Arthroplasty Is More Frequent in Asian Patients

Kim,

Park,

Baek

et al. 2023

JPM

View full text Add to dashboard Cite

Purpose: There is lack of intraoperative consensus on the distal femur anterior resected surface shape that allows reliable rotational alignment assessment during total knee arthroplasty (TKA). We aimed to evaluate the ratio and prevalence of anterior femoral resection surface intraoperatively. Materials and Methods: The study included 234 osteoarthritis patients with varus knees and not valgus knees or deformities. After conventional medial parapatellar approach, measured resection technique based on the mechanical axis of the femur and preoperative TEA-PCA angle on CT with anterior reference was used among all the patients. The anteroposterior (AP) lengths after distal femoral resection were measured as the femoral lateral AP (FLAP) and femoral medial AP (FMAP) lengths. Based on the medial (MD) and lateral condyle (LD) vertical distance ratios of the femur anterior resected surface, the groups were classified into “boot sign”, “grand-piano”, and “butterfly sign” groups. For comparison of the mean values, the data were assessed for normality with the Shapiro–Wilk test. One-way ANOVA with post hoc analysis using Tukey’s honestly significant difference (HSD) test was used to compare the mean values among the groups. The correlations between the MD/LD and variables were analyzed using the Pearson correlation coefficient. Linear regression analyses were used to find the associated factors to the anterior femoral resection surface shape. Results: Mean intraoperative femoral rotation and distal femoral cutting angles were 4.9° ± 1.2 and valgus 5.0° ± 0.7, respectively. Mean FLAP was 52.9 ± 4.2 mm. Mean MD/LD (0.61 ± 0.13) was lower than that of typical “grand-piano sign”. The morphological shape incidence of the “boot sign” was 62.4%. In the “boot sign” group, the FLAP was found to be smaller than that in the other groups (52.4 ± 4.2 vs. 53.7 ± 4.2 vs. 54.9 ± 2.7; p = 0.02), while the intraoperative femoral rotation angle was found to be larger than in the other groups (5.0 ± 1.2 vs. 4.6 ± 1.1 vs. 4.7 ± 1.2; p = 0.039). The MD/LD-associated factors were FLAP, intraoperative femoral rotation, and distal femoral cutting angles (R2 = 0.268). Conclusion: The femur anterior resection surface shape in TKA was found in the “boot sign” rather than the “grand-piano sign” in Korean ethnics owing to an asymmetric morphology of femoral condyles. Ethnic differences, including distal femoral morphology, should be considered for assessment of the femoral rotation angle using the femur anterior resection surface shape.

show abstract

The Influence of Femoral Internal Rotation on Patellar Tracking in Total Knee Arthroplasty Using Gap Technique

Cited by 10 publications

References 17 publications

Coronal alignment in total knee arthroplasty: a review

Coronal alignment in total knee arthroplasty: a review

Biomechanical Effects of Stem Extension of Tibial Components for Medial Tibial Bone Defects in Total Knee Arthroplasty: A Finite Element Study

“Boot Sign” of Anterior Femoral Condylar Resectional Shape during Total Knee Arthroplasty Is More Frequent in Asian Patients

Contact Info

Product

Resources

About