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BMC Surgery
Published in: BMC Surgery 1/2016

Open Access 01-12-2016 | Research article

Total knee arthroplasty using trochlear groove as guide for position of femoral component in severe knee osteoarthritis

Authors: Gangyong Huang, Jun Xia, Siqun Wang, Yibing Wei, Jianguo Wu, Feiyan Chen, Jie Chen, Jingsheng Shi

Published in: BMC Surgery | Issue 1/2016

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Abstract

Background

Apart from transepicondylar axis, the native femoral sulcus was also reported to be used as a guide for the femoral component position in total knee arthroplasty (TKA). However, it was not shown in patients with severe knee osteoarthritis. This study was conducted to compare the position of trochlear groove in patients with and without osteoarthritis, and to assess whether trochlear groove could be used as a guide for position of femoral component in TKA for severe knee osteoarthritis.

Methods

Total 50 severe knee osteoarthritis patients (Kellgren Lawrence grade 3 or 4) who underwent TKA were included. Meanwhile, 50 patients who underwent arthroscopic surgery without osteoarthritis were included as control. The distance from trochlear groove to the midpoint of a virtual anterior condyle osteotomy line (parallel to the posterior condyle line) (a–b) was recorded by radiological and surgical measurements. Midpoint of transepicondylar axis and trochlear groove were used as guide for placing prosthesis model in TKA, respectively. No-thumb test was performed to assess the patellar tracking. The position of femoral component was finally performed using trochlear groove as guide in TKA.

Results

Value of “a–b” was significantly different between osteoarthritic and control knees (P = 0.008). During the placement of prosthesis model, similar patellar tracking was detected between using midpoint of transepicondylar axis and trochlear groove as guide (P > 0.05). After placing femoral component using trochlear groove as guide, most patients obtained good patellofemoral congruence with pneumatic tourniquet inflated (n = 43) or deflated (n = 5), and good patellofemoral congruence was also obtained by lateral patellar retinaculum release in two patients.

Conclusion

Despite the shifting of trochlear groove caused by severe knee osteoarthritis, trochlear groove can be used as a guide for position of femoral component, with equivalent patellar tracking compared with transepicondylar axis.
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Metadata
Title
Total knee arthroplasty using trochlear groove as guide for position of femoral component in severe knee osteoarthritis
Authors
Gangyong Huang
Jun Xia
Siqun Wang
Yibing Wei
Jianguo Wu
Feiyan Chen
Jie Chen
Jingsheng Shi
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2016
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-016-0148-z

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