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Is it possible to re-establish pre-operative patellar kinematics using a ligament-balanced technique in total knee arthroplasty? A cadaveric investigation

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Abstract

Purpose

Several authors emphasise that the appearance of patellar maltracking after total knee arthroplasty (TKA) is caused by rotational malalignment of the femoral and tibial components. Ligament-balanced femoral component rotation was not found to be associated with abnormal postoperative patellar position. We hypothesised that a ligament-balanced technique in TKA has the ability to best re-establish patellar kinematics.

Methods

In ten cadaveric knees TKA was performed assessing femoral rotation in ligament-balanced and different femoral and tibial component rotation alignments. Patellar kinematics after different component rotations were analysed using a commercial computer navigation system.

Results

Ligament-balanced femoral rotation showed the best re-establishment of patellar kinematics after TKA compared to the healthy pre-operative knee. In contrast to tibial component rotation, femoral component rotation had a major impact on patellofemoral kinematics.

Conclusions

This investigation suggests that a ligament-balanced technique in TKA is most likely to re-establish natural patellofemoral kinematics. Tibial component rotation did not influence patellar kinematics.

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The authors declare that they have no conflict of interest.

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Correspondence to Armin Keshmiri.

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Keshmiri, A., Springorum, H., Baier, C. et al. Is it possible to re-establish pre-operative patellar kinematics using a ligament-balanced technique in total knee arthroplasty? A cadaveric investigation. International Orthopaedics (SICOT) 39, 441–448 (2015). https://doi.org/10.1007/s00264-014-2507-7

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  • DOI: https://doi.org/10.1007/s00264-014-2507-7

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