NDLI: Rotational alignment of femoral component with different methods in total knee arthroplasty: a randomized, controlled trial

Content Provider	Springer Nature : BioMed Central
Author	Lee, Joon Kyu Lee, Sahnghoon Chun, Sae Hyung Kim, Ki Tae Lee, Myung Chul
Abstract	Background Femoral component rotation (FCR) is one of the most important factors in total knee arthroplasty. In this prospective study, we used three different techniques for FCR and analyzed their accuracy with postoperative axial computed tomography (CT) images. We also evaluated effect of FCR to clinical outcome. Methods One hundred sixty-five patients were randomly allocated into three groups. In the measured resection group, FCR was set by externally rotating the axis 3° off the posterior femoral condylar axis. In the tensor group, a gap-tensioning device set at 20 lbf was used. In the block group, spacer blocks of various thicknesses were used. The FCR angle (FCRa) was measured on postoperative axial CT as an angle between the clinical transepicondylar and posterior condylar axes of the femoral component. Outliers were defined as FCRas deviated more than 3° either internally or externally. Postoperative 2 year clinical scores and knee range of motion were checked. Results The tensor group had significantly better positioning of the femoral component to the neutral position compared with the measured resection group and the block group (mean FCRa: internal rotation 1.79, 0.43 and 2.63°, respectively, p < 0.001). The outliers were also least frequent in the tensor group (35, 16 and 40%, respectively, p = 0.02). There were no significant differences in postoperative 2 year clinical results among groups. Conclusions Gap technique with a 20-lbf tensor device was the most accurate and precise method for obtaining adequate FCR. Measured resection with 3° external rotation and gap technique with blocks could lead to internal rotation of the femoral component. Postoperative 2 year clinical results were not significantly different among groups with different techniques for FCR. Trial registration The study was registered in the Clinical Research information Service (trial number: KCT0000129 ) in Korea. Registration date is 23rd of June, 2011.
Related Links	https://bmcmusculoskeletdisord.biomedcentral.com/counter/pdf/10.1186/s12891-017-1574-5.pdf
Ending Page	7
Page Count	7
Starting Page	1
File Format	HTM / HTML
ISSN	14712474
DOI	10.1186/s12891-017-1574-5
Journal	BMC Musculoskeletal Disorders
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2017-05-25
Access Restriction	Open
Subject Keyword	Orthopedics Rehabilitation Rheumatology Sports Medicine Internal Medicine Epidemiology Femoral component rotation Gap technique Measured resection technique Tensor device
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Rheumatology
Journal Impact Factor	2.2/2023
5-Year Journal Impact Factor	2.6/2023

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