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 .
Small Improvements in Postoperative Outcome with Gap Balancing Technique Compared with Measured Resection in Total Knee Arthroplasty
Background : There is ongoing debate about how to obtain correct rotational alignment in total knee arthroplasty ( TKA ) . Two commonly used techniques are the measured resection ( MR ) and the gap balancing ( GB ) technique . Objective : The objective of the present study was to analyze which of these two techniques confers a clinical advantage up to 10 years postoperatively . Methods : Two hundred patients were r and omized to either MR or GB .  The primary outcome was the Knee Society Knee Score ( KS ) 10 years postoperatively . Secondary outcomes were passive range of motion , the Knee Society Function Score ( FS ) , and the Western Ontario and McMasters Universities Osteoarthritis Index ( WOMAC ) , along with implant survival . We employed a two one-sided test ( TOST ) and linear mixed models to assess clinical outcomes . Results : Mean KS was 82 ( 95 % confidence interval ( CI ) , 80 – 83 ) and 77 ( 95 % CI , 76 – 79 ) in the GB and MR group , respectively . The TOST test and linear mixed model both revealed statistical significance ( p < 0.001 ) . In addition , GB yielded better postoperative FS and WOMAC . However , between-group differences were consistently small . Implant survival rates at 10 years , with survival for any reason as the endpoint of interest , were 93.7 % ( 95 % CI , 86.4 % and 97.1 % ) and 89.8 % ( 95 % CI , 81.9 % - 94.4 % ) for the GB group and the MR group , respectively ( p = 0.302 ) . Conclusion : Gap-balancing is a safe and reliable technique . KS for the two study groups at 10 years can be considered equivalent , and the small postoperative advantages may not extend beyond clinical relevance
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 .