The EKA Femoral Rotation Focus Group has not identified a single best reference method to determine femoral component rotation , but surgeons mostly prefer the measured resection technique using at least two l and marks for cross-checking the rotation .
Malrotation of the femoral component after primary total knee arthroplasty ( TKA ) is one of the most important problems leading to painful TKA requiring revision surgery .
A comprehensive systematic review of the literature was performed to present current evidence on how to optimally place the femoral component in TKA .
Comparison between two computer-assisted total knee arthroplasty: gap-balancing versus measured resection technique
Two surgical strategies are possible in total knee arthroplasty ( TKA ) : a measured resection technique , in which bone l and marks are used to guide resections equal to the distal and posterior thickness of the femoral component , or a gap-balancing approach , in which equal collateral ligament tension in flexion and extension is sought before and as a guide to final bone cuts . In this study performed with computer assisted system , we compared the 2 different methods in 126 patients followed prospect ively in order to analyze the effect of both the techniques on joint-line ( JL ) maintenance , axial limb restoration and components position . The gap technique showed a statistical increase in the post-operative value when compared with the measured resection technique , ( P = 0.008 ) . When comparing the two groups regarding to the pre-operative deformity , we have found a statistical difference ( P = 0.001 ) in case of moderate pre-operative deformity ( less than 10 ° ) , and the measured resection technique showed a slight superiority in preserving a joint line more faithful to the pre-operative . We found an ideal alignment for the mechanical axis ( 180 ° ± 3 ° ) ( 95 % of cases ) . In six cases ( 5 % ) , the mean post-operative value exceeded ( varus or valgus ) the ideal value by more than 3 ° . In the frontal plane , a good alignment was observed for both femoral and tibial components without a significant difference between the two techniques . In the sagittal plane was found more alignment variability due to the different implants used and their ideal starting slope , from 7 ° to 3 ° . Finally , the surgeon can use the approach with which he has more confidence ; however , as the measured resection technique causes less reduction in the post-operative joint-line position , in case of shortening of patellar tendon or patella infera , this technique is preferable
The EKA Femoral Rotation Focus Group has not identified a single best reference method to determine femoral component rotation , but surgeons mostly prefer the measured resection technique using at least two l and marks for cross-checking the rotation .
Malrotation of the femoral component after primary total knee arthroplasty ( TKA ) is one of the most important problems leading to painful TKA requiring revision surgery .
A comprehensive systematic review of the literature was performed to present current evidence on how to optimally place the femoral component in TKA .