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Change in tibiofemoral rotational alignment during total knee arthroplasty

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Rotational mismatch between femoral and tibial components has been recognized as a risk factor of unsuccessful total knee arthroplasty (TKA), but a main cause of rotational mismatch is uncertain. This study aims to evaluate rotational alignment of the knee by measuring both component rotation and version of the knee in TKA.

Method

Fifty-one TKAs (mean age 73.7 years) were included in this study. The three dimensional, weight-bearing knee alignment was measured before and after TKA. A transepicondylar axis was referenced to femoral component rotation, and an anteroposterior axis of the tibia (middle of posterior cruciate ligament attachment to medial border of patella tendon attachment) was referenced to tibial component rotation. Knee rotational angle was defined as the angle between these two axes.

Result

The mean preoperative knee rotation angle of 9.7° (±8.5°) internal rotation was significantly reduced to 1.8° (±7.3°) external rotation after TKA. Twenty-one of 51 knees (41 %) exhibited rotational mismatch (>10°) preoperatively, and this number was reduced to eight knees (16 %) post-TKA. The femoral component was rotationally aligned within 5° of neutral in all knees, while rotational alignment of the tibial component showed a high degree of variability (range 20.7° internal rotation to 17.2° external rotation).

Conclusion

Rotational malposition of the tibial component was considered to be a main factor of rotational mismatch of the knee after TKA.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan

    Satoshi Watanabe & Naoto Endo

  2. Department of Orthopaedic Surgery, Niigata Medical Center, Niigata, Japan

    Takashi Sato & Yoshio Koga

  3. Center for Transdisciplinary Research, Niigata University, Niigata, Japan

    Go Omori

Authors
  1. Satoshi Watanabe
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  2. Takashi Sato
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  3. Go Omori
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  4. Yoshio Koga
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  5. Naoto Endo
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Corresponding author

Correspondence to Satoshi Watanabe.

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Watanabe, S., Sato, T., Omori, G. et al. Change in tibiofemoral rotational alignment during total knee arthroplasty. J Orthop Sci 19, 571–578 (2014). https://doi.org/10.1007/s00776-014-0565-8

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  • DOI: https://doi.org/10.1007/s00776-014-0565-8

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