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. 2006 Oct;30(5):420-5.
doi: 10.1007/s00264-006-0085-z. Epub 2006 Mar 7.

Femoral component rotation and arthrofibrosis following mobile-bearing total knee arthroplasty

J G Boldt  1 , J B Stiehl, J Hodler, M Zanetti, U Munzinger
Affiliations

Femoral component rotation and arthrofibrosis following mobile-bearing total knee arthroplasty

J G Boldt et al. Int Orthop. 2006 Oct.

Abstract
in English, French

The purpose of this study was to evaluate the femoral component rotation in a small subset of patients who had developed arthrofibrosis after mobile-bearing total knee arthroplasty (TKA). Arthrofibrosis was defined as flexion less than 90 degrees or a flexion contracture greater than 10 degrees following TKA. From a consecutive cohort of 3,058 mobile-bearing TKAs, 49 (1.6%) patients were diagnosed as having arthrofibrosis, of which 38 (86%) could be recruited for clinical assessment. Femoral rotation of a control group of 38 asymptomatic TKA patients matched for age, gender, and body mass index was also evaluated. The surgical epicondylar axis was compared with the posterior condylar axis for the femoral prosthesis. Femoral components in the arthrofibrosis group were significantly internally rotated by a mean of 4.7 degrees (SD 2.2 degrees , range 10 degrees internal to 1 degrees external). In the control group, the femoral component had a mean 0.3 degrees internal rotation (SD 2.3 degrees , range 4 degrees internal to 6 degrees external). Following mobile-bearing TKA, there is a significant correlation between internal femoral component rotation and chronic arthrofibrosis.

Le propos de cette étude est d’évaluer la rotation du composant fémoral des sujets ayant développé une raideur du genou après prothèse à plateau mobile. La raideur du genou se définit comme une flexion inférieure à 90° avec un défaut d’extension de 10°. Sur une cohorte consécutive de 3 058 prothèses du genou à plateau mobile 1,6% ont présenté une raideur. 86% de ces patients ont pu être évalués cliniquement. La rotation du composant fémoral, outre le contrôle de 38 patients évalués, de même que l’âge, le sexe, le BMI. L’axe épicondylien a été comparé à l’axe du condyle postérieur, les composants fémoraux chez les sujets présentant une raideur du genou étaient, de manière significative, une rotation interne en moyenne de 4,7° (10° de rotation interne à 1° de rotation externe). Dans le groupe contrôle, le composant fémoral ne présentait que 0,3° de rotation interne (4° interne, 6° externe). Il existe donc une corrélation significative chez ces patients après prothèse à plateau mobile du genou entre la raideur du genou et la rotation du composant fémoral.

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Figures

Fig. 1
Fig. 1
Surgical technique resects the proximal tibial surface perpendicular to the mechanical axis of the tibia and resects the posterior condyles to create a rectangular flexion space
Fig. 2
Fig. 2
a Distal femoral posterior condylar resection is done using an intramedullary fixed resection block that is tensed with a spacer. b Sagittal plane view demonstrates position of the resection block with anterior cortical reference
Fig. 3
Fig. 3
Transverse computed tomogram through the surgical transepicondylar axis allows calculation of the posterior condylar angle of the femoral total knee prosthesis
See this image and copyright information in PMC

Comment in

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