We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Widening of tibial resection boundaries increases the rate of femoral component valgus and internal rotation in functionally aligned TKA.
- Authors
Ollivier, Britt; Wakelin, Edgar; Plaskos, Christopher; Vandenneucker, Hilde; Luyckx, Thomas
- Abstract
Purpose: The purpose of this study was to investigate the influence of increasing the tibial boundaries in functional alignment on femoral component orientation in total knee arthroplasty (TKA). Methods: A retrospective review of a database of robotic‐assisted TKAs using a digital joint tensioning device was performed (BalanceBot®; Corin). A total of 692 TKAs with correctable deformity were included. Functional alignment with a tibia‐first balancing technique was simulated by performing an anatomic tibial resection to recreate the native medial proximal tibial angle within certain boundaries (A, 87–90°; B, 86–90°; C, 84–92°), while accounting for wear. After balancing the knee, the resulting amount of femoral component outliers in the coronal and axial plane was calculated for each group and correlated to the coronal plane alignment of the knee (CPAK) classification. Results: The proportion of knees with high femoral component varus (>96°) or valgus (<87°) alignment increased from 24.5% (n = 170) in group A to 26.5% (n = 183) in group B and 34.2% (n = 237) in group C (p < 0.05). Similarly, more knees with high femoral component external rotation (>6°) or internal rotation (>3°) were identified in group C (33.4%, n = 231) than in group B (23.7%, n = 164) and A (18.4%, n = 127) (p < 0.05). There was a statistically significant (p < 0.01) overall increase in knees with both femoral component valgus <87° and internal rotation >3° from group A (4.0%, n = 28) to B (7.7%, n = 53) and C (15.8%, n = 109), with CPAK type I and II showing a 12.9‐ and 2.9‐fold increase, respectively. Conclusion: Extending the tibial boundaries when using functional alignment with a tibia‐first balancing technique in TKA leads to a statistically significant higher percentage of knees with a valgus lateral distal femoral angle < 87° and >3° internal rotation of the femoral component, especially in CPAK type I and II. Level of Evidence: Level IV.
- Subjects
FEMUR; ANATOMICAL planes; TOTAL knee replacement; ROTATIONAL motion
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2024, Vol 32, Issue 4, p953
- ISSN
0942-2056
- Publication type
Article
- DOI
10.1002/ksa.12118