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 .
Rotational alignment of femoral component with different methods in total knee arthroplasty: a randomized, controlled trial
Background Femoral component rotation ( FCR ) is one of the most important factors in total knee arthroplasty . In this prospect i ve study , we used three different techniques for FCR and analyzed their accuracy with postoperative axial computed tomography ( CT ) images . We also evaluated effect of FCR to clinical outcome . Methods One hundred sixty-five patients were r and omly allocated into three groups . In the measured resection group , FCR was set by externally rotating the axis 3 ° off the posterior femoral condylar axis . In the tensor group , a gap-tensioning device set at 20 lbf was used . In the block group , spacer blocks of various thicknesses were used . The FCR angle ( FCRa ) was measured on postoperative axial CT as an angle between the clinical transepicondylar and posterior condylar axes of the femoral component . Outliers were defined as FCRas deviated more than 3 ° either internally or externally . Postoperative 2 year clinical scores and knee range of motion were checked . Results The tensor group had significantly better positioning of the femoral component to the neutral position compared with the measured resection group and the block group ( mean FCRa : internal rotation 1.79 , 0.43 and 2.63 ° , respectively , p < 0.001 ) . The outliers were also least frequent in the tensor group ( 35 , 16 and 40 % , respectively , p = 0.02 ) . There were no significant differences in postoperative 2 year clinical results among groups . Conclusions Gap technique with a 20-lbf tensor device was the most accurate and precise method for obtaining adequate FCR . Measured resection with 3 ° external rotation and gap technique with blocks could lead to internal rotation of the femoral component . Postoperative 2 year clinical results were not significantly different among groups with different techniques for FCR.Trial registration The study was registered in the Clinical Research information Service ( trial number : KCT0000129 ) in Korea . Registration date is 23rd of June , 2011
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 .