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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2017

Open Access 01-12-2017 | Research article

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

Authors: Joon Kyu Lee, Sahnghoon Lee, Sae Hyung Chun, Ki Tae Kim, Myung Chul Lee

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

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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.
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Metadata
Title
Rotational alignment of femoral component with different methods in total knee arthroplasty: a randomized, controlled trial
Authors
Joon Kyu Lee
Sahnghoon Lee
Sae Hyung Chun
Ki Tae Kim
Myung Chul Lee
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-017-1574-5

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