scholarly journals Combining the Sulcus Line and Posterior Condylar Axis Reduces Femoral Malrotation in Total Knee Arthroplasty

2016 ◽  
Vol 4 (2_suppl) ◽  
pp. 2325967116S0001
Author(s):  
Simon Talbot ◽  
Tat Woon Chao ◽  
Liam Geraghty
2019 ◽  
Vol 33 (10) ◽  
pp. 971-977
Author(s):  
Diana K. Lee ◽  
Matthew J. Grosso ◽  
David P. Trofa ◽  
Julian J. Sonnenfeld ◽  
H. John Cooper ◽  
...  

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.


2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0010
Author(s):  
Zeki Taşdemir ◽  
Hüseyin Bilgehan Çevik ◽  
Nurzat Elmalı ◽  
Özgür Baysal

Objectives: Purpose of this study is to as certain consistency between posterior condylar axis (PCA) + 3˚ external rotation line and clinical transepicondylar axis (cTEA) line in primary total knee arthroplasty cases. Materials-Methods: During surgery, following distal femoral cut PCA +3 degree external rotation line and cTEA line drawn on the distal femoral cutting surface by ruler and pencil. The both lines on distal femur were recorded by digital camera and relationship between lines was ascertained in reference to PCA +3 degree external rotation [parallel (P), Internal rotation (IR) and External Rotation (ER)]. Results: 9 knees of 9 patients [1 men, 8 women; average age 67 (59-80 age)] were constituted the study group. Evaluation results of the photographs revealed that clinical TEA line in comparison PCA +3 degrees external rotation line was ER in 9 knees (100%) whose mean angles 2.7˚ (1-6) and detected external roation with mean angle 4.7˚ (2-7) in 9 knees. Conclusion:: For determination of FC rotation in surgery setting, different results between cTEA and PCA + 3 degrees techniques possibly may due to disadvantages of techniques and anatomic variation of distal femur. Thus, using both techniques for check each other’s results seems unsafe. In custom made prosthesis, which can be done in the future it will be measured by CT. Keywords: Total knee arthroplasty, femoral component, rotational alignment, femoral transepicondylar axis, posterior condylar axis


2019 ◽  
Vol 139 (8) ◽  
pp. 1141-1147 ◽  
Author(s):  
Nina Wuertele ◽  
Johannes Beckmann ◽  
Malin Meier ◽  
Jochen Huth ◽  
Wolfgang Fitz

The Knee ◽  
2014 ◽  
Vol 21 (6) ◽  
pp. 1120-1123 ◽  
Author(s):  
Andrew Park ◽  
Stephen T. Duncan ◽  
Ryan M. Nunley ◽  
James A. Keeney ◽  
Robert L. Barrack ◽  
...  

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