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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-02-2012 | Knee

Comparison of the tibiofemoral rotational alignment after mobile and fixed bearing total knee arthroplasty

Authors: Dongwook Kim, Sang Cheol Seong, Myung Chul Lee, Sahnghoon Lee

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2012

Abstract

Purpose

The anatomical landmark for the anteroposterior (AP) axis of the proximal tibia and its variability was investigated in order to determine whether a certain landmark could be employed as a reference axis for the proximal tibia after the rotating platform mobile bearing and fixed bearing total knee arthroplasties (TKAs).

Methods

Eighty primary osteoarthritic knees were randomized to undergo either rotating platform mobile bearing (Group A, n = 40) or fixed bearing (Group B, n = 40) TKAs, and were followed up for 31 and 30 months, respectively. The AP axes were defined for the distal femur, proximal tibia, ankle, and each TKA component on the reconstructed CT scan and the angles between the distal femoral AP axis and those of each bone or component were estimated. Clinical and radiographic outcomes were evaluated during the follow up.

Results

A significant difference was seen between the preoperative and postoperative rotational position of the proximal tibia relative to the distal femur following rotating platform mobile bearing TKA (P = 0.014) whereas no such difference was seen after fixed bearing TKA. The mean postoperative alignment of the tibia differed between the two groups (Group A:Group B = −2.9:0.2, P = 0.010) and its variability was significantly greater in group A (P < 0.001). There were no differences in the clinical outcomes including range of motion, knee society score, function score, HSS, and WOMAC score as well as the mean postoperative coronal tibiofemoral alignment between the two groups.

Conclusion

The unpredictable change in the rotational axis of the tibia and its broad variability after rotating platform mobile bearing TKA may provide a warning against the use of a fixed landmark for establishing tibial rotational alignment.

Level of evidence

Prospective comparative study, Level II.

Akagi M, Matsusue Y, Mata T, Asada Y, Horiguchi M, Iida H, Nakamura T (1999) Effect of rotational alignment on patellar tracking in total knee arthroplasty. Clin Orthop Relat Res 366:155–163PubMedCrossRef

Akagi M, Oh M, Nonaka T, Tsujimoto H (2004) An anteroposterior axis of the tibia for total knee arthroplasty. Clin Orthop Relat Res 420:213–219PubMedCrossRef

Akagi M, Mori S, Nishimura S, Nishimura A, Asano T, Hamanishi C (2005) Variability of extraarticular tibial rotation references for total knee arthroplasty. Clin Orthop Relat Res 436:172–176PubMedCrossRef

Anouchi YS, Whiteside LA, Kaiser AD, Milliano MT (1993) The effects of axial rotational alignment of the femoral component on knee stability and patellar tracking in total knee arthroplasty demonstrated on autopsy specimens. Clin Orthop Relat Res 287:170–177PubMed

Barrack RL, Schrader T, Bertot AJ, Wolfe MW, Myers L (2001) Component rotation and anterior knee pain after total knee arthroplasty. Clin Orthop Relat Res 392:46–55PubMedCrossRef

Berger RA, Crossett LS, Jacobs JJ, Rubash HE (1998) Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res 356:144–153PubMedCrossRef

Berger RA, Rubash HE, Seel MJ, Thompson WH, Crossett LS (1993) Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res 286:40–47PubMed

Cobb JP, Dixon H, Dandachli W, Iranpour F (2008) The anatomical tibial axis: reliable rotational orientation in knee replacement. J Bone Joint Surg Br 90:1032–1038PubMedCrossRef

D’Lima DD, Trice M, Urquhart AG, Colwell CW (2000) Comparison between the kinematics of fixed and rotating bearing knee prostheses. Clin Orthop Relat Res 380:151–157PubMedCrossRef

10.

Dalury DF (2001) Observations of the proximal tibia in total knee arthroplasty. Clin Orthop Relat Res 389:150–155PubMedCrossRef

11.

Eckhoff DG, Johnston RJ, Stamm ER, Kilcoyne RF, Wiedel JD (1994) Version of the osteoarthritic knee. J Arthroplasty 9:73–79PubMedCrossRef

12.

Fehring TK (2000) Rotational malalignment of the femoral component in total knee arthroplasty. Clin Orthop Relat Res 380:72–79PubMedCrossRef

13.

Fisher J, McEwen H, Tipper J, Jennings L, Farrar R, Stone M, Ingham E (2006) Wear-simulation analysis of rotating-platform mobile-bearing knees. Orthopedics 29:S36–S41PubMed

14.

Fisher J, McEwen HMJ, Tipper JL, Galvin AL, Ingram J, Kamali A, Stone MH, Ingham E (2004) Wear, debris, and biologic activity of cross-linked polyethylene in the knee: benefits and potential concerns. Clin Orthop Relat Res 428:114–119PubMedCrossRef

15.

Graw BP, Harris AH, Tripuraneni KR, Giori NJ (2010) Rotational references for total knee arthroplasty tibial components change with level of resection. Clin Orthop Relat Res 468:2734–2738PubMedCrossRef

16.

Harwin SF, Greene KA, Hitt K (2008) Triathlon total knee arthroplasty: 4-year outcomes with a high-performance implant. J Knee Surg 21:320–326PubMed

17.

Jazrawi LM, Birdzell L, Kummer FJ, Di Cesare PE (2000) The accuracy of computed tomography for determining femoral and tibial total knee arthroplasty component rotation. J Arthroplasty 15:761–766PubMedCrossRef

18.

Jeffery RS, Morris RW, Denham RA (1991) Coronal alignment after total knee replacement. J Bone Joint Surg Br 73:709–714PubMed

19.

Jung Y-B, Lee HJ, Jung HJ, Song KS, Lee JS, Yang JJ (2009) Comparison of the radiological results between fluoroscopy-assisted and navigation-guided total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 17:286–292PubMedCrossRef

20.

Lewis P, Rorabeck CH, Bourne RB, Devane P (1994) Posteromedial tibial polyethylene failure in total knee replacements. Clin Orthop Relat Res 299:11–17PubMed

21.

Matsuda S, White SE, Williams VG, McCarthy DS, Whiteside LA (1998) Contact stress analysis in meniscal bearing total knee arthroplasty. J Arthroplasty 13:699–706PubMedCrossRef

22.

Miller MC, Berger RA, Petrella AJ, Karmas A, Rubash HE (2001) Optimizing femoral component rotation in total knee arthroplasty. Clin Orthop Relat Res 392:38–45PubMedCrossRef

23.

Mizu-uchi H, Matsuda S, Miura H, Higaki H, Okazaki K, Iwamoto Y (2006) The effect of ankle rotation on cutting of the tibia in total knee arthroplasty. J Bone Joint Surg Am 88:2632–2636PubMedCrossRef

24.

Moreland JR (1988) Mechanisms of failure in total knee arthroplasty. Clin Orthop Relat Res 226:49–64PubMed

25.

Nagamine R, Whiteside LA, White SE, McCarthy DS (1994) Patellar tracking after total knee arthroplasty. The effect of tibial tray malrotation and articular surface configuration. Clin Orthop Relat Res 304:262–271PubMed

26.

Olcott CW, Scott RD (1999) The Ranawat Award. Femoral component rotation during total knee arthroplasty. Clin Orthop Relat Res 367:39–42PubMedCrossRef

27.

Page SR, Deakin AH, Payne AP, Picard F (2011) Reliability of frames of reference used for tibial component rotation in total knee arthroplasty. Comput Aided Surg 16:86–92PubMedCrossRef

28.

Poilvache PL, Insall JN, Scuderi GR, Font-Rodriguez DE (1996) Rotational landmarks and sizing of the distal femur in total knee arthroplasty. Clin Orthop Relat Res 331:35–46PubMedCrossRef

29.

Radtke K, Becher C, Noll Y, Ostermeier S (2010) Effect of limb rotation on radiographic alignment in total knee arthroplasties. Arch Orthop Trauma Surg 130:451–457PubMedCrossRef

30.

Rand JA (1994) The patellofemoral joint in total knee arthroplasty. J Bone Joint Surg Am 76:612–620PubMed

31.

Rand JA, Coventry MB (1988) Ten-year evaluation of geometric total knee arthroplasty. Clin Orthop Relat Res 232:168–173PubMed

32.

Rhoads DD, Noble PC, Reuben JD, Mahoney OM, Tullos HS (1990) The effect of femoral component position on patellar tracking after total knee arthroplasty. Clin Orthop Relat Res 260:43–51PubMed

33.

Ritter MA, Faris PM, Keating EM (1994) Postoperative alignment of total knee replacement its effect on survival. Clin Orthop Relat Res 299:153–156PubMed

34.

Wasielewski RC, Galante JO, Leighty RM, Natarajan RN, Rosenberg AG (1994) Wear patterns on retrieved polyethylene tibial inserts and their relationship to technical considerations during total knee arthroplasty. Clin Orthop Relat Res 299:31–43PubMed

35.

Whiteside LA, Arima J (1995) The anteroposterior axis for femoral rotational alignment in valgus total knee arthroplasty. Clin Orthop Relat Res 321:168–172PubMed

36.

Yagi T, Sasaki T (1986) Tibial torsion in patients with medial-type osteoarthritic knee. Clin Orthop Relat Res 213:177–182PubMed

37.

Yoshioka Y, Siu DW, Scudamore RA, Cooke TD (1989) Tibial anatomy and functional axes. J Orthop Res 7:132–137PubMedCrossRef

Title: Comparison of the tibiofemoral rotational alignment after mobile and fixed bearing total knee arthroplasty
Authors: Dongwook Kim
Sang Cheol Seong
Myung Chul Lee
Sahnghoon Lee
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2012
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-011-1750-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of the tibiofemoral rotational alignment after mobile and fixed bearing total knee arthroplasty

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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