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Published in: International Orthopaedics 12/2012

01-12-2012 | Original Paper

The benefit of revision knee arthroplasty for component malrotation after primary total knee replacement

Authors: Amir Sternheim, Jasjit Lochab, Michael Drexler, Paul Kuzyk, Oleg Safir, Allan Gross, David Backstein

Published in: International Orthopaedics | Issue 12/2012

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Abstract

Purpose

Revision surgery for component malrotation in the painful TKA is a relatively novel indication. The purpose of this study was to assess the benefit of revision TKA for component malrotation with regard to the clinical and functional outcomes.

Methods

Our retrospective case–control study included 51 patients who underwent revision surgery for malrotation with mean follow up of 42 months. They were equally matched to patients who had surgery for aseptic loosening.

Results

Knee society scores improved from 44/49 to 75/60 (p < 0.001) for the study group and 44/47 to 76/57 (p < 0.001) for the control group. There was no statistical difference between the groups, including for VAS scores, narcotic reduction or patient satisfaction. Our study showed that revision surgery for malrotation is as beneficial as surgery for aseptic loosening with regard to clinical and functional outcome.

Conclusions

We recommend CT in painful TKA to assess component malrotation for which revision TKA is beneficial.
Literature
1.
go back to reference Anonymous (2011) Australian Orthopaedic Association National Joint Replacement Registry Annual Report for 2011. Australian Orthopaedic Association, Sydney Anonymous (2011) Australian Orthopaedic Association National Joint Replacement Registry Annual Report for 2011. Australian Orthopaedic Association, Sydney
4.
go back to reference 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, Crossett LS, Jacobs JJ, Rubash HE (1998) Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res 356:144–153PubMedCrossRef
5.
go back to reference Eckhoff DG, Metzger RG, Vandewalle MV (1995) Malrotation associated with implant alignment technique in total knee arthroplasty. Clin Orthop Relat Res 321:28–31PubMed Eckhoff DG, Metzger RG, Vandewalle MV (1995) Malrotation associated with implant alignment technique in total knee arthroplasty. Clin Orthop Relat Res 321:28–31PubMed
6.
go back to reference Hofmann S, Romero J, Roth-Schiffl E, Albrecht T (2003) Rotational malalignment of the components may cause chronic pain or early failure in total knee arthroplasty. Orthopade 32:469–476. doi:10.1007/s00132-003-0503-5 PubMed Hofmann S, Romero J, Roth-Schiffl E, Albrecht T (2003) Rotational malalignment of the components may cause chronic pain or early failure in total knee arthroplasty. Orthopade 32:469–476. doi:10.​1007/​s00132-003-0503-5 PubMed
8.
go back to reference Lakstein D, Zarrabian M, Kosashvili Y, Safir O, Gross AE, Backstein D (2010) Revision total knee arthroplasty for component malrotation is highly beneficial: a case control study. J Arthroplast 25:1047–1052. doi:10.1016/j.arth.2009.07.004 CrossRef Lakstein D, Zarrabian M, Kosashvili Y, Safir O, Gross AE, Backstein D (2010) Revision total knee arthroplasty for component malrotation is highly beneficial: a case control study. J Arthroplast 25:1047–1052. doi:10.​1016/​j.​arth.​2009.​07.​004 CrossRef
9.
go back to reference Pietsch M, Hofmann S (2012) Early revision for isolated internal malrotation of the femoral component in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 20(6):1057–1063. doi:10.1007/s00167-011-1637-3 Pietsch M, Hofmann S (2012) Early revision for isolated internal malrotation of the femoral component in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 20(6):1057–1063. doi:10.​1007/​s00167-011-1637-3
10.
go back to reference Keating EM, Meding JB, Faris PM, Ritter MA (2002) Long-term followup of nonmodular total knee replacements. Clin Orthop Relat Res 404:34–39PubMedCrossRef Keating EM, Meding JB, Faris PM, Ritter MA (2002) Long-term followup of nonmodular total knee replacements. Clin Orthop Relat Res 404:34–39PubMedCrossRef
11.
go back to reference 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 Arthroplast 15:761–766. doi:10.1054/arth.2000.8193 CrossRef 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 Arthroplast 15:761–766. doi:10.​1054/​arth.​2000.​8193 CrossRef
12.
go back to reference van der Linden-van der Zwaag HM, Bos J, van der Heide HJ, Nelissen RG (2011) A computed tomography based study on rotational alignment accuracy of the femoral component in total knee arthroplasty using computer-assisted orthopaedic surgery. Int Orthop 35:845–850. doi:10.1007/s00264-010-1082-9 PubMedCrossRef van der Linden-van der Zwaag HM, Bos J, van der Heide HJ, Nelissen RG (2011) A computed tomography based study on rotational alignment accuracy of the femoral component in total knee arthroplasty using computer-assisted orthopaedic surgery. Int Orthop 35:845–850. doi:10.​1007/​s00264-010-1082-9 PubMedCrossRef
13.
go back to reference Rienmuller A, Guggi T, Gruber G, Preiss S, Drobny T (2012) The effect of femoral component rotation on the five-year outcome of cemented mobile bearing total knee arthroplasty. Int Orthop. doi:10.1007/s00264-012-1628-0 Rienmuller A, Guggi T, Gruber G, Preiss S, Drobny T (2012) The effect of femoral component rotation on the five-year outcome of cemented mobile bearing total knee arthroplasty. Int Orthop. doi:10.​1007/​s00264-012-1628-0
14.
go back to reference Thompson JA, Hast MW, Granger JF, Piazza SJ, Siston RA (2011) Biomechanical effects of total knee arthroplasty component malrotation: a computational simulation. J Orthop Res 29:969–975. doi:10.1002/jor.21344 PubMedCrossRef Thompson JA, Hast MW, Granger JF, Piazza SJ, Siston RA (2011) Biomechanical effects of total knee arthroplasty component malrotation: a computational simulation. J Orthop Res 29:969–975. doi:10.​1002/​jor.​21344 PubMedCrossRef
16.
Metadata
Title
The benefit of revision knee arthroplasty for component malrotation after primary total knee replacement
Authors
Amir Sternheim
Jasjit Lochab
Michael Drexler
Paul Kuzyk
Oleg Safir
Allan Gross
David Backstein
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 12/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-012-1675-6

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