Background: Femoral component rotation in total knee arthroplasty (TKA) has a significant impact on balance and patellofemoral kinematics. However, normal anatomic relationships between rotational axes are poorly understood. As such, we sought to characterize anatomic femoral rotational axes in patients undergoing primary TKA.
Methods: We identified 100 patients who underwent a primary TKA with a preoperative computed tomography scan. The angles between the surgical epicondylar axis (SEA) and the anterior-posterior (AP) axis to the posterior condylar axis (PCA) were measured independently by a musculoskeletal fellowship-trained radiologist and a fellowship-trained arthroplasty surgeon. We simulated an ideal TKA in which the femoral component was placed exactly 3° external to the PCA and measured resulting rotation.
Results: The SEA was on average 1.5° externally rotated to the PCA (range 3.1° internal to 7.0° external). The AP axis was on average 4.5° externally rotated to the PCA (range 2.3° internal to 10.3° external). The AP axis was a mean 2.7° externally rotated to the SEA (range 6.3° internal to 10.3° external). Routinely setting femoral rotation 3° external to the PCA would result in only 51 (51%) TKAs within ±2° of the SEA and 23 (23%) femoral components internally rotated relative to the SEA.
Conclusion: Normal anatomic rotational axes of arthritic knees are highly variable, with a 10° range in the SEA and 16° range in the AP axis. Routinely setting femoral rotation 3° external to the PCA will yield significant error in aligning the femoral component with either the SEA or AP axis.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.arth.2020.12.028 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Mapping the spatial atlas of the human bone tissue integrating spatial and single-cell transcriptomics.
Nucleic Acids Res
January 2025
Tulane Center for Biomedical Informatics and Genomics, Deming Department of Medicine, School of Medicine, Tulane University, 1440 Canal Street, Downtown, New Orleans, LA 70112, USA.
Bone is a multifaceted tissue requiring orchestrated interplays of diverse cells within specialized microenvironments. Although significant progress has been made in understanding cellular and molecular mechanisms of component cells of bone, revealing their spatial organization and interactions in native bone tissue microenvironment is crucial for advancing precision medicine, as they govern fundamental signaling pathways and functional dependencies among various bone cells. In this study, we present the first integrative high-resolution map of human bone and bone marrow, using spatial and single-cell transcriptomics profiling from femoral tissue.
View Article and Find Full Text PDFGuide-wire and K-wire readjustment jig for osteotomy and osteosynthesis: An instrument.
J Clin Orthop Trauma
February 2025
Joints and Spine Clinic, Mahavir Nagar, Kandivali West, Mumbai, 400067, India.
Introduction: Numerous orthopaedic procedures including dynamic hip screw plating and various osteotomies require placement of a reference guide pin or K wire to direct bone cuts or for drilling screw holes. Appropriate positioning of these wires is a critical component of surgery. Irrespective of whether one is a seasoned surgeon or an apprentice, these wires often need repositioning and readjustment.
View Article and Find Full Text PDFIntraprosthetic Dislocation Following Dual Mobility Total Hip Arthroplasty: A Retrieval Analysis Study.
Arthroplast Today
February 2025
Department of Orthopaedic Surgery, Fiona Stanley Fremantle Hospitals Group, Murdoch, Western Australia, Australia.
Background: Dual mobility (DM) implants in total hip arthroplasty provide excellent range of motion with low dislocation rates. A complication of this design is intraprosthetic dislocation (IPD), where the polyethylene (PE) liner dissociates from the femoral head. In older designs, IPD occurred due to a small head size and late PE wear with head-capture-mechanism failure.
View Article and Find Full Text PDFVersatility of the Anterolateral Thigh Flap for Abdominal Wall Reconstruction.
Plast Reconstr Surg Glob Open
January 2025
From the Department of Plastic Surgery and Hand Surgery, Cantonal Hospital Aarau, Aarau, Switzerland.
Background: Abdominal wall reconstruction represents an ambitious and demanding challenge. This study aimed to illustrate the versatility of the anterolateral thigh (ALT) flap in its different designs for the reconstruction of complex defects of the abdominal wall.
Methods: Charts of patients with complex abdominal wall defects who underwent a reconstruction with an ALT flap at the University Hospital of Zurich (2018-2020) were reviewed retrospectively.
Higher bone cement volume in total knee arthroplasty lowers the risk of postoperative radiolucent lines.
Knee Surg Sports Traumatol Arthrosc
January 2025
Department of Orthopedics and Trauma, Medical University of Graz, Graz, Austria.
Purpose: >The aim of this multicenter study was to analyze the potential impact of patient demographics and cementation technique towards the development of radiolucent lines (RLLs) in primary total knee arthroplasty (TKA). It was hypothesized that cementation techniques, including higher cement volume, double-layer cementation technique and hardening in full extension, reduce RLL incidence by improving stability, whereas demographic factors such as age, BMI and smoking may increase RLL risk by affecting bone quality and mechanical loading.
Methods: Altogether, 776 patients (median age: 70.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!