Sagittal alignment of the cemented femoral component in revision total knee arthroplasty influences the anterior and posterior condylar offset: Stem length does not affect these variables

The Knee ◽  
2020 ◽  
Vol 27 (2) ◽  
pp. 477-484
Author(s):  
N. Ng ◽  
J.T. Patton ◽  
R. Burnett ◽  
N.D. Clement
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Sagittal Alignment ◽  
Revision Total Knee Arthroplasty ◽  
Stem Length ◽  
Posterior Condylar Offset ◽  
Posterior Condylar ◽  
Total Knee

Influence of stem length on component flexion and posterior condylar offset in revision total knee arthroplasty

The Knee ◽  
2018 ◽  
Vol 25 (3) ◽  
pp. 480-484 ◽  
Author(s):  
Max Ettinger ◽  
Peter Savov ◽  
Omar Balubaid ◽  
Henning Windhagen ◽  
Tilman Calliess
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Stem Length ◽  
Posterior Condylar Offset ◽  
Posterior Condylar ◽  
Total Knee

scholarly journals The role of joint line position and restoration of posterior condylar offset in revision total knee arthroplasty : a systematic review of 422 revision knees arthroplasty

2021 ◽  
Vol 87 (3) ◽  
pp. 453-460
Author(s):  
Hany Elbardesy ◽  
André McLeod ◽  
Rehan Gul ◽  
James Harty
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Joint Line ◽  
Level Of Evidence ◽  
Posterior Condylar Offset ◽  
Upper Limit ◽  
Posterior Condylar ◽  
Total Knee

The aim of this systematic review was to evaluate the evidence on reservation of Posterior Femoral Condylar Offset (PFCO) and Joint Line (JL) after Revision Total Knee Arthroplasty (RTKA) for im- proved functional outcomes. A comprehensive search of PubMed, Medline, Cochrane, CINAHL, and Embase databases was conducted, with papers published from the inception of the database to October 2020 included. All relevant articles were retrieved, and their bibliographies were hand searched for further references on Posterior condylar offset and revision total knee arthroplasty. The search strategy yielded 28 articles. After duplicate titles were excluded, abstracts and full text were reviewed. Nine studies were assessed for eligibility, four studies were excluded because they did not fully comply with the inclusion criteria. Six articles were finally included in this systematic review. Based on this systematic review restoration of the JL and PFCO in RTKR is associated with a significant improvement in the post-operative range of motion, KSS, OKS, patellar function, and SF-36. Reservation of JL should be a major consideration when undertaking RTKA. Of note, increasing PFCO to balance the flexion gap while maintaining joint line should be well assessed intra-operatively. The upper limit of the PFCO that widely accepted is up to 40 % greater than that of the native knee. 4 mm is the upper limit for JL restoration. Level of evidence III.

Pain associated with cemented and uncemented long-stemmed tibial components in revision total knee arthroplasty

2021 ◽  
Vol 103-B (6 Supple A) ◽  
pp. 165-170
Author(s):  
Darin J. Larson ◽  
John H. Rosenberg ◽  
Maxwell A. Lawlor ◽  
Kevin L. Garvin ◽  
Curtis W. Hartman ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Stem Length ◽  
Exact Test ◽  
Patient Dissatisfaction ◽  
Total Knee ◽  
Revision Tka

Aims Stemmed tibial components are frequently used in revision total knee arthroplasty (TKA). The purpose of this study was to evaluate patient satisfaction, overall pain, and diaphyseal tibial pain in patients who underwent revision TKA with cemented or uncemented stemmed tibial components. Methods This is a retrospective cohort study involving 110 patients with revision TKA with cemented versus uncemented stemmed tibial components. Patients who underwent revision TKA with stemmed tibial components over a 15-year period at a single institution with at least two-year follow-up were assessed. Pain was evaluated through postal surveys. There were 63 patients with cemented tibial stems and 47 with uncemented stems. Radiographs and Knee Society Scores were used to evaluate for objective findings associated with pain or patient dissatisfaction. Postal surveys were analyzed using Fisher’s exact test and the independent-samples t-test. Logistic regression was used to adjust for age, sex, and preoperative bone loss. Results No statistically significant differences in stem length, operative side, or indications for revision were found between the two cohorts. Tibial pain at the end of the stem was present in 25.3% (16/63) of cemented stems and 25.5% (12/47) of uncemented stems (p = 1.000); 74.6% (47/63) of cemented patients and 78.7% (37/47) of uncemented patients were satisfied following revision TKA (p = 0.657). Conclusion There were no differences in patient satisfaction, overall pain, and diaphyseal tibial pain in cemented and uncemented stemmed tibial components in revision TKA. Patient factors, rather than implant selection and surgical technique, likely play a large role in the presence of postoperative pain. Stemmed tibial components have been shown to be a possible source of pain in revision TKA. There is no difference in patient satisfaction or postoperative pain with cemented or uncemented stemmed tibial components in revision TKA. Cite this article: Bone Joint J 2021;103-B(6 Supple A):165–170.

Incidence of Femoral Component Malrotation Using Posterior Condylar Referencing in Total Knee Arthroplasty

2019 ◽  
Vol 33 (10) ◽  
pp. 971-977
Author(s):  
Diana K. Lee ◽  
Matthew J. Grosso ◽  
David P. Trofa ◽  
Julian J. Sonnenfeld ◽  
H. John Cooper ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
External Rotation ◽  
Prognostic Impact ◽  
Posterior Condylar Axis ◽  
Femoral Component Rotation ◽  
Component Rotation ◽  
Posterior Condylar ◽  
Total Knee

AbstractProper femoral component rotation in total knee arthroplasty (TKA) is important, given the prognostic impact of a poorly positioned component. The purpose of this observational study was to determine the incidence of femoral component malrotation using posterior condylar axis (PCA) referencing. A total of 100 knees in 92 patients with varus gonarthritis of the knee undergoing primary TKA using a standard medial parapatellar approach were evaluated intraoperatively. After distal femoral resection, the standard femoral sizing guide referencing the posterior condylar axis was used to set femoral component rotation. This was then compared with both the transepicondylar (TEA) and trochlear anteroposterior axes (TRAx). Disparites were recorded and corrected in line with the epicondylar axis. Rotational adjustment for addition of further external rotation was made in 13 (13.0%) cases. In seven cases, the medial pin sites were raised between 1 and 3 mm, and in six cases, the lateral pin site was lowered between 1 and 3 mm (based on risk of notching the femoral cortex). It is critical to not rely exclusively on the PCA to confirm rotational positioning of the femoral component as predicted by posterior condylar referencing guides. Intraoperative adjustment and confirmation using the TEA and TRAx occurred in 13% of primary TKA cases, which might have, otherwise, had a significant effect on the clinical outcome.

scholarly journals Stem length in revision total knee arthroplasty

2015 ◽  
Vol 8 (4) ◽  
pp. 407-412 ◽  
Author(s):  
Anay Rajendra Patel ◽  
Brian Barlow ◽  
Amar S. Ranawat
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Stem Length ◽  
Total Knee

Does Posterior Condylar Offset Affect Clinical Results following Total Knee Arthroplasty?

2017 ◽  
Vol 31 (08) ◽  
pp. 754-760 ◽  
Author(s):  
Ryan Degen ◽  
Jacob Matz ◽  
Matthew Teeter ◽  
Brent Lanting ◽  
James Howard ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Outcome Measures ◽  
Knee Arthroplasty ◽  
Short Form ◽  
Clinical Results ◽  
Patient Reported Outcome Measures ◽  
Posterior Condylar Offset ◽  
Patient Reported ◽  
Posterior Condylar ◽  
Total Knee

AbstractTotal knee arthroplasty (TKA) is an effective, durable treatment for knee osteoarthritis. However, a subset of patients experiences incomplete pain relief and ongoing dysfunction. Posterior condylar offset (PCO) has previously been shown to be associated with postoperative range of motion (ROM) following TKA; however, an association with patient-reported outcome measures (PROMs) has not been established. The purpose of this study was to evaluate the association between PCO and postoperative ROM and PROMs. A retrospective review of 970 posterior-stabilized single design TKAs was performed. Preoperative and postoperative radiographs were analyzed to measure the change in PCO and anteroposterior (AP) femoral dimension. Clinical outcome measures, including Short Form-12 physical and mental component summaries, Western Ontario and McMaster Universities Arthritis Index, and Knee Society Score were reviewed to determine if these were influenced by changes in PCO and AP dimension. PCO was increased by more than 3 mm in 15.1%, maintained (within 3 mm) in 59.6%, and decreased by more than 3 mm in 25.3% of patients. Comparing between these groups, there were no significant differences in postoperative ROM or PROM. AP dimension increased in 24.4%, maintained in 47.8%, and decreased in 27.8%. Similarly, there were no significant differences in ROM or PROM between these groups. Spearman's correlation analyses failed to identify an association between PCO and ROM or PROMs. In conclusion, increasing or decreasing PCO or AP femoral dimension with this PS TKA design did not significantly affect postoperative ROM or PROM. Similarly, maintenance of PCO within one implant size with this system compared with optimal sizing had no deleterious effect on TKA outcomes.

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