Impact of Axial Component Alignment in Total Knee Arthroplasty on Lower Limb Rotational Alignment: An in Vitro Study
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In: Journal of Knee Surgery, Vol. 30.2017, No. 4, 01.05.2017, p. 372-377.
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TY - JOUR
T1 - Impact of Axial Component Alignment in Total Knee Arthroplasty on Lower Limb Rotational Alignment
T2 - An in Vitro Study
AU - Maderbacher, Guenther
AU - Baier, Clemens
AU - Springorum, Hans Robert
AU - Maderbacher, Hermann
AU - Birkenbach, Anne Maria
AU - Benditz, Achim
AU - Grifka, Joachim
AU - Keshmiri, Armin
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Correct rotational implant alignment is associated with increased postoperative function and implant survival in total knee arthroplasty (TKA). Due to conformity between tibial and femoral implants, particularly in full extension, we assumed a mutual interference of femoral and tibial component rotations. We, therefore, hypothesized that different rotational alignments of the tibial or femoral components change the rotational postures between the tibia and femur after TKA. In 10 healthy knees of whole body cadavers, TKA was performed. Both femoral and tibial components were implanted in different internal (6 degrees) and external (3 and 6 degrees) rotational alignments. Consequential osseous rotational changes between the tibia and the femur were measured in full extension using a commercial computer navigation device. External rotation of the femoral component resulted in significant external rotation of the tibia, while external rotation of the tibial component caused a significant internal rotation of the tibia. The opposite applied to femoral and tibial component internal rotations. Therefore, largest changes of the osseous tibiofemoral rotational postures were found by the combination of 6 degrees femoral component internal and 6 degrees tibial component external rotations (mean 11.2 degrees, standard deviation 5.0, p < 0.001), as both cause tibial internal rotation. In conclusion, the present results suggest that axial component alignment significantly affects lower limb rotational alignment. However, its clinical impact on forefoot progression, Q-angle, the patella, collateral, and cruciate ligaments, and surrounding soft tissues has to be clarified in further clinical and biomechanical studies.
AB - Correct rotational implant alignment is associated with increased postoperative function and implant survival in total knee arthroplasty (TKA). Due to conformity between tibial and femoral implants, particularly in full extension, we assumed a mutual interference of femoral and tibial component rotations. We, therefore, hypothesized that different rotational alignments of the tibial or femoral components change the rotational postures between the tibia and femur after TKA. In 10 healthy knees of whole body cadavers, TKA was performed. Both femoral and tibial components were implanted in different internal (6 degrees) and external (3 and 6 degrees) rotational alignments. Consequential osseous rotational changes between the tibia and the femur were measured in full extension using a commercial computer navigation device. External rotation of the femoral component resulted in significant external rotation of the tibia, while external rotation of the tibial component caused a significant internal rotation of the tibia. The opposite applied to femoral and tibial component internal rotations. Therefore, largest changes of the osseous tibiofemoral rotational postures were found by the combination of 6 degrees femoral component internal and 6 degrees tibial component external rotations (mean 11.2 degrees, standard deviation 5.0, p < 0.001), as both cause tibial internal rotation. In conclusion, the present results suggest that axial component alignment significantly affects lower limb rotational alignment. However, its clinical impact on forefoot progression, Q-angle, the patella, collateral, and cruciate ligaments, and surrounding soft tissues has to be clarified in further clinical and biomechanical studies.
KW - lower limb rotational alignment
KW - navigation
KW - rotational alignment
KW - TKA
KW - total knee arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=84988407749&partnerID=8YFLogxK
U2 - 10.1055/s-0036-1592148
DO - 10.1055/s-0036-1592148
M3 - Article
C2 - 27642773
AN - SCOPUS:84988407749
VL - 30.2017
SP - 372
EP - 377
JO - Journal of Knee Surgery
JF - Journal of Knee Surgery
SN - 1538-8506
IS - 4
ER -