Rotational Alignment of the Femoral Component in Total Knee Replacement: Ligament Balance, Tibial Reference, and Femoral Component Sizing

2004 ◽  
Vol 3 (2) ◽  
pp. 89-96
Author(s):  
John M. Clark
Keyword(s):  
Total Knee Replacement ◽  
Femoral Component ◽  
Knee Replacement ◽  
Rotational Alignment ◽  
Component Sizing ◽  
Ligament Balance ◽  
Total Knee

scholarly journals Migration of the femoral component and clinical outcomes after total knee replacement: a narrative review

2020 ◽  
Author(s):  
R. Zinno ◽  
S. Di Paolo ◽  
G. Ambrosino ◽  
D. Alesi ◽  
S. Zaffagnini ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Clinical Outcomes ◽  
Femoral Component ◽  
Knee Replacement ◽  
Narrative Review ◽  
Alternative Solution ◽  
Total Knee ◽  
Long Term Performance ◽  
Term Performance ◽  
Cobalt Chrome

AbstractLoosening is considered as a main cause of implant failure in total knee replacement (TKR). Among the predictive signs of loosening, migration is the most investigated quantitative parameter. Several studies focused on the migration of the tibial component in TKR, while no reviews have been focused on the migration of the femoral component and its influence on patients’ clinical outcomes. The aim of this narrative review was (1) to provide information about of the influence of migration in femoral component of TKR prostheses, (2) to assess how migration may affect patient clinical outcomes and (3) to present alternative solution to the standard cobalt-chrome prostheses. A database search was performed on PubMed Central® according to the PRISMA guidelines for studies about Cobalt-Chrome femoral component migration in people that underwent primary TKR published until May 2020. Overall, 18 articles matched the selection criteria and were included in the study. Few studies investigated the femoral component through the migration, and no clear migration causes emerged. The Roentgen Stereophotogrammetric Analysis has been mostly used to assess the migration for prognostic predictions. An annual migration of 0.10 mm seems compatible with good long-term performance and good clinical and functional outcomes. An alternative solution to cobalt-chrome prostheses is represented by femoral component in PEEK material, although no clinical evaluations have been carried out on humans yet. Further studies are needed to investigate the migration of the femoral component in relation to clinical outcomes and material used.

The Effects of Resection Technique on Implant Migration in Single Radius Posterior-Stabilized Total Knee Replacement

2018 ◽  
Vol 33 (01) ◽  
pp. 078-083
Author(s):  
Matthew G. Teeter ◽  
Kevin Perry ◽  
Xunhua Yuan ◽  
James L. Howard ◽  
Brent A. Lanting
Keyword(s):  
Total Knee Replacement ◽  
Femoral Component ◽  
Knee Replacement ◽  
Tibial Component ◽  
Posterior Stabilized ◽  
Gap Balancing ◽  
Measured Resection ◽  
Total Knee ◽  
Single Radius ◽  
Component Migration

AbstractThe purpose of the present study was to measure the effects of gap balancing and resection techniques on migration of a single total knee replacement implant design. A total of 23 patients (24 knees) were recruited on referral to either a surgeon performing gap balancing or a surgeon performing measured resection and followed prospectively. All patients received a fixed bearing, posterior stabilized total knee replacement implant of a single radius femoral component design with cement fixation, and all aspects of care outside of resection technique were identical. Patients underwent radiostereometric analysis (RSA) at 2 weeks (baseline), 6 weeks, 3 months, 6 months, 1 year, and 2 years. Migration of the tibial and femoral components was compared between groups. Tibial component migration was greater at 2 years in the gap balancing group (mean difference = 0.336 mm, p = 0.036), but there was no difference at 1 year. One measured resection and three gap balancing tibial components demonstrated continuous migration > 0.2 mm between years 1 and 2. There was no difference in femoral component migration. Small differences in tibial component migration were found between the gap balancing and measured resection techniques. However, comparing the migration to established predictive thresholds for long-term loosening risk, implants performed with both techniques were found to have equally low revision risk.

scholarly journals Computed tomography is not necessary to assess rotation of the femoral component in navigation-assisted total knee replacement

2016 ◽  
Vol 44 (6) ◽  
pp. 1314-1322 ◽  
Author(s):  
Daniel Hernández-Vaquero ◽  
Alfonso Noriega-Fernandez ◽  
Ivan Perez-Coto ◽  
Manuel A. Sandoval García ◽  
Andres A. Sierra-Pereira ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Knee Replacement ◽  
Femoral Component ◽  
Knee Replacement ◽  
Transepicondylar Axis ◽  
Component Rotation ◽  
Preoperative Ct ◽  
Total Knee ◽  
The Mean ◽  
Ct Data

Objective To demonstrate that postoperative computed tomography (CT) is not needed if navigation is used to determine the rotational position of the femoral component during total knee replacement (TKR). Methods Preoperative CT, navigational, and postoperative CT data of 70 TKR procedures were analysed. The correlation between the rotational angulation of the femur measured by CT and that measured by perioperative navigation was examined. The correlation between the femoral component rotation determined by navigation and that determined by CT was also assessed. Results The mean femoral rotation determined by navigation was 2.64° ± 4.34°, while that shown by CT was 6.43° ± 1.65°. Postoperative rotation of the femoral component shown by CT was 3.09° ± 2.71°, which was closely correlated with the angle obtained through the intraoperative transepicondylar axis by navigation (Pearson’s R = 0.930). Conclusions Navigation can be used to collect the preoperative, intraoperative, and postoperative data and final position of the TKR. The rotation of the femoral component can be determined using navigation without the need for CT.

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