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International Orthopaedics
Published in: International Orthopaedics 6/2012

01-06-2012 | Original Paper

Contemporary femoral designs in total knee arthroplasty: effects on the patello-femoral congruence

Authors: Pier Francesco Indelli, Massimiliano Marcucci, Donatella Cariello, Paolo Poli, Massimo Innocenti

Published in: International Orthopaedics | Issue 6/2012

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Abstract

Purpose

The objective of this study was to evaluate the radiological and clinical correlations between implant design and patellar positioning in patients who underwent TKA utilizing femoral implants with modern designs.

Methods

Thirty consecutive PFC PS Sigma TKAs, characterized by a new prolonged anterior flange and a “smoother” trochlea, were prospectively reviewed. All patellae were replaced. All patients were evaluated pre-operatively and prospectively at two years follow-up both clinically according to the Knee Society score as well as radiographically. This included computed tomography (CT); patellar tilt, patellar conformity angle, patellar lateralization, and femoral component external-rotation in relation to the clinical trans-epicondylar axis.

Results

Average patellar tilt at follow-up was 3° (±7.5°) with respect to a pre-operative 18.5° (±8.5°). Average patellar congruence angle at follow-up was −3° (range, −11° to +9°) with respect to a pre-operative 10.3° (range, + 1.5° to 25.5°). Average lateralization index at follow-up was 2.7 mm (range, −3.4 mm to +7.1 mm) with respect to a pre-operative 12.2 mm (± 4.8 mm). Femoral component positioning related to the trans-epicondylar axis showed an external rotation of 2.80° (± 2.10°) at follow-up with respect to 5.7° (± 1.80°). Clinically, two (6.6%) patients reported patello-femoral complications related to imperfections in the surgical technique more than the implant's design.

Conclusions

This study highlighted that modern femoral designs in TKA allow for a correct reproducibility of a normal patello-femoral conformity. Strict surgical principles are paramount to avoid patello-femoral complications even when modern implants are used.
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Metadata
Title
Contemporary femoral designs in total knee arthroplasty: effects on the patello-femoral congruence
Authors
Pier Francesco Indelli
Massimiliano Marcucci
Donatella Cariello
Paolo Poli
Massimo Innocenti
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 6/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-011-1454-9

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