Clinical Outcome of IM-Guided Total Knee Arthroplasty with Inappropriate Femoral Resection in Coronal Plane
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Purpose: The purpose of this study was to evaluate clinical results and accuracy of femoral cutting in the coronal plane in total knee arthroplasty (TKA) using a fixed length intramedullary guide. Materials and Methods: From 2005 to 2008, 101 patients (154 knees) underwent TKA (NexGen LPS implant). The minimal follow-up period was 3 years (mean, 4.4 years). The patients were divided into two groups (group 1, 94≤α angle<98; group 2, 94>α, 98≤α). Mechanical axis deviation (MAD), patellar tilting angle (PTA), Knee Society Knee Score (KSKS), and Knee Society Function Score (KSFS) were measured in both groups. Results: There were 120 knees in group 1 and 34 knees in group 2. There was no significant intergroup difference in the postoperative MAD (group 1, 1.59o; group 2, 1.91o). The number of outliers with ≥2o MAD was 65 in group 1 and 24 in group 2. The mean PTA, KSKS, and KSFS were 10.17o, 96.0, and 96.6, respectively, in group 1 and 11.58o, 84.5, and 85.5, respectively, in group 2. Conclusions: The percentage of coronal alignment outliers was relatively high (34 in 154 cases, 22%) after TKA using a fixed length intramedullary guide. However, there was no statistically significant intergroup difference in clinical results (KSKS, p=0.67; KSFS, p=0.56).
Abstract
Purpose: The purpose of this study was to evaluate clinical results and accuracy of femoral cutting in the coronal plane in total knee arthroplasty (TKA) using a fixed length intramedullary guide. Materials and Methods: From 2005 to 2008, 101 patients (154 knees) underwent TKA (NexGen LPS implant). The minimal follow-up period was 3 years (mean, 4.4 years). The patients were divided into two groups (group 1, 94≤α angle<98; group 2, 94>α, 98≤α). Mechanical axis deviation (MAD), patellar tilting angle (PTA), Knee Society Knee Score (KSKS), and Knee Society Function Score (KSFS) were measured in both groups. Results: There were 120 knees in group 1 and 34 knees in group 2. There was no significant intergroup difference in the postoperative MAD (group 1, 1.59o; group 2, 1.91o). The number of outliers with ≥2o MAD was 65 in group 1 and 24 in group 2. The mean PTA, KSKS, and KSFS were 10.17o, 96.0, and 96.6, respectively, in group 1 and 11.58o, 84.5, and 85.5, respectively, in group 2. Conclusions: The percentage of coronal alignment outliers was relatively high (34 in 154 cases, 22%) after TKA using a fixed length intramedullary guide. However, there was no statistically significant intergroup difference in clinical results (KSKS, p=0.67; KSFS, p=0.56).
참고문헌 (17)
- Tew M, "Tibiofemoral alignment and the results of knee replacement", J Bone Joint Surg Br, 67, pp.551~556 (1985)
- Ritter MA, "Postoperative alignment of total knee replacement: its effect on survival", Clin Orthop Relat Res, 299, pp.153~156 (1994)
- Hungerford DS, "Alignment in total knee replacement", Instr Course Lect, 44, pp.455~468 (1995)
- Hungerford DS, "Total joint arthroplasty of the knee", Clin Orthop Relat Res, 192, pp.23~33 (1985)
- Sikorski JM, "Computer-assisted revision total knee replacement", J Bone Joint Surg Br, 86, pp.510~514 (2004)
- Longstaff LM, "Good alignment after total knee arthroplasty leads to faster rehabilitation and better function", J Arthroplasty, 24, pp.570~578 (2009)
- Moreland JR, "Mechanisms of failure in total knee arthroplasty", Clin Orthop Relat Res, 226, pp.49~64 (1988)
- Townley CO, "The anatomic total knee resurfacing arthroplasty", Clin Orthop Relat Res, 192, pp.82~96 (1985)
- Cates HE, "Intramedullary versus extramedullary femoral alignment systems in total knee replacement", Clin Orthop Relat Res, 286, pp.32~39 (1993)
- Lotke PA, "Influence of positioning of prosthesis in total knee replacement", J Bone Joint Surg Am, 59, pp.77~79 (1977)
- Insall JN, "Total knee arthroplasty", Clin Orthop Relat Res, 192, pp.13~22 (1985)
- Petersen TL, "Radiographic assessment of knee alignment after total knee arthroplasty", J Arthroplasty, 3, pp.67~72 (1988)
- Reed SC, "The accuracy of femoral intramedullary guides in total knee arthroplasty", J Arthroplasty, 12, pp.677~682 (1997)
- Jiang CC, "Effect of rotation on the axial alignment of the femur: pitfalls in the use of femoral intramedullary guides in total knee arthroplasty", Clin Orthop Relat Res, 248, pp.50~56 (1989)
- Stulberg SD, "Computer-assisted navigation in total knee replacement: results of an initial experience in thirty-five patients", J Bone Joint Surg Am, 84(Suppl 2), pp.90~98 (2002)
- Chauhan SK, "Computer-assisted knee arthroplasty versus a conventional jig-based technique : a randomised, prospective trial", J Bone Joint Surg Br, 86, pp.372~377 (2004)
- Sparmann M, "Positioning of total knee arthroplasty with and without navigation support : a prospective, randomised study", J Bone Joint Surg Br, 85, pp.830~835 (2003)