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Computed tomographic evaluation of femoral component rotation in total knee arthroplasty

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Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background

Optimal femoral component rotational alignment in total knee arthroplasty (TKA) is crucial to establish a balanced knee reconstruction. Unbalanced knees can lead to instability, patellofemoral problems, persistent pain, stiffness, and generally poorer outcomes including early failure. Intraoperative techniques to achieve this optimal femoral component rotation include the use of the transepicondylar axis (TEA), the posterior-condylar-cut-parallel-to-the-tibial-cut (PCCPTC) technique and the anteroposterior axis technique (Whiteside’s line). The purpose of this study was to compare the PCCPTC technique to the TEA technique using computed tomography (CT) scans to assess femoral component rotational alignment.

Materials and Methods

This study used postoperative CT scans to compare the degree of femoral component rotation obtained with the use of PCCPTC technique and the TEA. The femoral component rotation of 30 TKA was measured on postoperative CT scans the angle of deviation between the two lines radiographic trans-epicondylar axis (rTEA) and femoral prosthesis posterior condylar line (FPPCL) was determined. This angle represented the rotation of the femoral component relative to the true rTEA.

Results

The degree of rotation measured 2.67 ± 1.11 degrees in the PCCPTC group and 5.60 ± 1.64 degrees in the TEA group.

Conclusion

The use of the TEA technique for determining rotational alignment in TKR results in excessive external rotation of the femoral component compared to the PCCPTC technique.

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Authors and Affiliations

  1. Medical College of Wisconsin, Milwaukee, WI, 53213, USA

    Vaibhav Bagaria (Spine Fellow)

  2. Department of Orthopaedic Surgery, Lenox Hill Hospital, USA

    Amar S. Ranawat

  3. Hospital for Special Surgery, New York, NY, 10021, USA

    Chitranjan S. Ranawat

  4. Department of Orthopaedics, King Edward VII Memorial Hospital, Parel, Mumbai, 400 012, India

    Shrinand V. Vaidya & Rajesh M. Gadhiya

Authors
  1. Shrinand V. Vaidya
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  2. Rajesh M. Gadhiya
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  3. Vaibhav Bagaria
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  4. Amar S. Ranawat
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  5. Chitranjan S. Ranawat
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Correspondence to Shrinand V. Vaidya.

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Vaidya, S.V., Gadhiya, R.M., Bagaria, V. et al. Computed tomographic evaluation of femoral component rotation in total knee arthroplasty. IJOO 47, 40–44 (2013). https://doi.org/10.4103/0019-5413.106898

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  • DOI: https://doi.org/10.4103/0019-5413.106898

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