1 / 12

Evaluating Femoral Rotation and Stability in Total Knee Arthroplasty Using Balanced Gap Technique

This study investigates the effects of femoral component rotation and laxities in total knee arthroplasty (TKA), focusing on the balanced gap technique. By employing a navigation system, we aimed to improve knee function and stability in 47 patients, documenting outcomes over a follow-up period of 54.5 months. Key findings reveal a positive correlation between femoral external rotation and varus alignment, alongside enhancements in functional scores like HSS and WOMAC. Ultimately, careful management of soft tissue balance was emphasized to mitigate malalignment risks.

snowy
Télécharger la présentation

Evaluating Femoral Rotation and Stability in Total Knee Arthroplasty Using Balanced Gap Technique

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Introducció • Twosurgicaltechniquesto determine FCER • Mesuredresectiontechnique • Balanced gap technique • Landmarks • Transepicondylar axis • Anterioposterior line • Posterior condylar line

  2. Introduction • Mesuredresectiontechnique • Trapezoidal flexion gap • Regardless of ligamenttension • Balanced gap technique • Cutparalleltothe proximal tibialcutting • Betterflexionstability • Betterpatellar tracking • Dependsonsofttissue balance • Could lead toundesirableimplantation

  3. Purposes • Determine femoral componentrotations and laxitiesusing a navigationsystemduring CR TKA usingbalanced gap technique • Evaluatetheeffects of femoral rotationonkneefunction

  4. Materials and Methods • Prospectivestudy • 47 patients • Exclusioncriteria: • Open kneesurgery • Severedeformity (>20º varusor >30º flexion) • Otherthanosteoarthritis • Follow-up 54,5 months (48-68) • 4 men and 40 women • Mean age 68,8 years (56-79)

  5. SurgicalTechnique • Medial parapatellarapproach (Patellareversion) • OrthoPilotnavigationsystem • Proximal tibialcutting 0º • PCL waspreserved • Tensioningdeviceforextension gap • Release medial structuresifnecessary • 4-in-1 cutting block paralleltothetibialresectionplane • Externalrotationrange 0-7º (Patellar tracking)

  6. Surgicaltechnique • Notallowedinternalrotation • ER >7º release anterior fiber of SMCL • CementedAesculap TKA • Patellawasnotresurfaced • Posterior slope 3º

  7. Materials and Methods • Clinicaloutcomes • Samephysicianassistant (notinvolved) • HSS, WOMAC, Rmotion, FT angles, Posterior femoral condyles offset, radiolucentlines • 3 and 12 months and annually • Statistics • PairedStudent t test • Pearsonregressionanalysis • SPSS • Distributionswere normal

  8. Results • Mean ER femoral component3,8 +/-2,4º • Mean kneemechanicalalignments: • 0º flexion: 0,6 +/-1,1º of varus • 90º flexion: 1,4 +/-2,6º of varus • Positive correlation (r:0,70 p<0,01) between FCER and varusalignment at 90º flexion • 8/14 with >6º ER: more than 3º varus • 2/30 with 0-5º ER: more than 3º varus 90º

  9. Results • Mean vr-vllaxitygreater at 90º • 90º: 5,8 +/-1,9º • 0º: 4,4 +/-1,4º • HSS and WOMAC improved • FT anglesimproved • Radiolucentlines 9/47

  10. Discussion • BG techniquegoodalignments and stability • More FCER, more varusknee at 90º flexion • No correlationbetween FCER and preoperativemechanicalangle • Hanada et al: Substantialvarusalignment at 90º flexion • Cadaverwithoutsofttissuerelease • Didnot set femoral externalrotation

  11. Discussion • Limitations • Intraoperativelaxitytestingmanually • Alignmentwasmeasuredunder non-weight-bearingconditions • Conclusion • Excessive FCER can beavoidedbyadditionalsofttissuebalancing, and preventsvarusmalalignment

More Related