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Archives of Orthopaedic and Trauma Surgery

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04-09-2021 | Knee Arthroplasty

Investigation of femoral condyle height changes during flexion of the knee: implication to gap balance in TKA surgery

Authors: Zhenming Zhang, Chaochao Zhou, Zhitao Rao, Timothy Foster, Hany Bedair, Guoan Li

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2022

Abstract

Background

Gap balance of the knee at 0° and 90° of flexion has been pursued in total knee arthroplasty (TKA) with the trans-epicondyle axis (TEA) as a reference. This study investigated the height changes of the tibiofemoral articulation and compared the data with the femoral condyle height changes measured using different flexion axes.

Materials and methods

Twenty healthy knees were investigated during an in vivo weightbearing flexion using a technique combining MRI and a dual fluoroscopic imaging system (DFIS). The tibiofemoral contact points and the femoral condyle heights [measured using: TEA, geometric center axis (GCA), and iso-height axis (IHA)] were determined at each flexion angle. The height changes of the articular contact points and the femoral condyles were compared along the flexion path.

Results

The changes of the medial and lateral contact point heights were within 2.5 mm along the flexion path. The changes of the medial and lateral condyle heights were within 8.9 mm for TEA, within 4.2 mm for GCA and within 3.0 mm for IHA. The height changes measured by the contact points and IHA are similar (p > 0.05), and both are significantly smaller than those measured using the TEA and GCA (p < 0.05).

Conclusions

The TEA and GCA measured varying femoral condyle heights, but the IHA resulted in minimal condyle height changes and could better represent the articulation characteristics of the knee. The data suggested that the IHA could be used as an alternative reference to guide surgical preparation of gap balance along the knee flexion path during TKA surgeries.

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Title: Investigation of femoral condyle height changes during flexion of the knee: implication to gap balance in TKA surgery
Authors: Zhenming Zhang
Chaochao Zhou
Zhitao Rao
Timothy Foster
Hany Bedair
Guoan Li
Publication date: 04-09-2021
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 10/2022
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-04155-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Investigation of femoral condyle height changes during flexion of the knee: implication to gap balance in TKA surgery

Abstract

Background

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

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