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 .
Computer-assisted gap balancing technique improves outcome in total knee arthroplasty, compared with conventional measured resection technique
Purpose The objective of this prospect i ve study was to compare the functional outcome of conventional measured resection technique and computer-assisted gap balancing technique in TKA . Methods 140 patients were r and omized into two groups . The conventional measured resection technique without computer navigation was performed in Group 1 and the computer-assisted gap balancing technique in Group 2 . Range of motion , clinical laxity assessment with KT-1000 arthrometer , postoperative radiological films and various functional knee scores were documented at 6 months and 2 years . Results At 2 years , there were significantly more patients ( five patients , 7 % ) in the Group 1 with flexion contractures of more than 5 ° ( P = 0.05 ) . There were significantly more outliers in the Group 1 ( eight patients , 11 % ) , who demonstrated anterior tibial translation > 5 mm , than Group 2 ( two patients , 3 % ) ( P = 0.041 ) . The total excursion at 20 ° was significantly higher in Group 1 at 6 months ( P = 0.012 ) and after 2 years ( P = 0.031 ) . Group 2 was able to demonstrate significantly better limb alignment with fewer outliers ( more than 3 ° varus/valgus ) than Group 1 . At 6-month follow-up , Group 2 demonstrated better outcomes in Function Score ( P = 0.040 ) and Total Oxford Score ( P = 0.031 ) . At 2-year review , Group 2 had better outcome in the Total Oxford Score ( 0.030 ) . Conclusion Computer-assisted gap balancing technique was able to achieve more precise soft tissue balance and restoration of limb alignment with better knee scores as compared to the conventional measured resection technique in total knee arthroplasty . Level of evidence
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 .