IMPACT OF DIFFERENCES OF POSTERIOR CONDYLE CARTILAGE WEAR ON ROTATIONAL POSITIONING OF FEMORAL PROSTHESIS IN TOTAL KNEE ARTHROPLASTY FOR OSTEOARTHRITIS PATIENTS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GAO Zhihui ¹ , SHI Xiaoqiang ² , FANG Xiaomin ² , BAO Liang ² , JIN Qunhua ¹

1The Third Department of Orthopedics, General Hospital of Ningxia Medical University, Yinchuan Ningxia, 750004, P.R.China;;
2Graduate School of Ningxia Medical University. Corresponding author: JIN Qunhua, E-mail: jinqunhua@sina.com;

Corresponding author：

Keywords：

Total knee arthroplasty; Femur posterior condylar cartilage; Posterior condylar angle; Prosthesis position

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the impact of difference between the medial and lateral posterior condyle cartilage thickness on osteotomy in total knee arthroplasty (TKA) by measuring the thickness of the medial and lateral femur posterior condylar cartilage and the posterior condylar angle (PCA) in osteoarthritis (OA) patients. Methods Between May and December 2011, 53 OA patients (60 knees) scheduled for TKA met the inclusion criteria (OA group). There were 12 males (14 knees) and 41 females (46 knees), aged 57-82 years (mean, 71.9 years). The tibiofemoral angle was (183.2 ± 2.6) ° . Fifteen healthy volunteers (30 knees) were taken as controls (control group); there were 6 males and 9 females, aged 59-68 years (mean, 66.3 years). MRI scan data were imported into Mimics10.01 medical image control system to measure the thickness of femur posterior condylar cartilage and the PCA with and without femur posterior condylar cartilage. Results In the control group, the thickness of the medial and lateral femur posterior condylar cartilage was (1.85 ± 0.33) mm and (1.92 ± 0.27) mm respectively, the PCA with and without femur posterior condylar cartilage was (5.0 ± 0.9)° and (5.1 ± 0.8)° respectively, all showing no significant differences (P gt; 0.05). In OA group, the thickness of the medial and lateral femur posterior condylar medial cartilage was (0.45 ± 0.40) mm and (1.78 ± 0.51) mm respectively, the PCA with and without femur posterior condylar cartilage was (3.3 ± 1.7)° and (4.8 ± 1.8)° respectively, all showing significant differences (P lt; 0.05). In OA group, the difference between lateral and medial cartilage thickness was (1.33 ± 0.45) mm, and the difference between PCA with and without femur posterior condylar cartilage was (1.5 ± 1.3)°. There was a positive correlation between the difference of cartilage thickness and the difference of PCA (r=0.75, P=0.01). Conclusion There is significant difference between medial and lateral femur posterior condylar cartilage wear, which leads to difference of PCA. The difference will impact knee function and longevity of the prosthesis, so the difference should be considered during osteotomy.

Citation： GAO Zhihui,SHI Xiaoqiang,FANG Xiaomin,BAO Liang,JIN Qunhua. IMPACT OF DIFFERENCES OF POSTERIOR CONDYLE CARTILAGE WEAR ON ROTATIONAL POSITIONING OF FEMORAL PROSTHESIS IN TOTAL KNEE ARTHROPLASTY FOR OSTEOARTHRITIS PATIENTS. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(10): 1174-1177. doi: Copy

1.	Thompson JA, Hast MW, Granger JF, et al. Biomechanical effects of total knee arthroplasty component malrotation: a computational simulation. J Orthop Res, 2011, 29(7): 969-975.
2.	Classen T, Wegner A, Müller RD, et al. Femoral component rotation and Laurin angle after total knee arthroplasty. Acta Orthop Belg, 2010, 76(1): 69-73.
3.	Berger RA, Rubash HE, Seel MJ, et al. Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res, 1993, (286): 40-47.
4.	Churchill DL, Incavo SJ, Johnson CC, et al. The transepicondylar axis approximates the optimal flexion axis of the knee. Clin Orthop Relat Res, 1998, (356): 111-118.
5.	Victor J. Rotational alignment of the distal femur: a literature review. Orthop Traumatol Surg Res, 2009, 95(5): 365-372.
6.	Akagi M, Yamashita E, Nakagawa T, et al. Relationship between frontal knee alignment and reference axes in the distal femur. Clin Orthop Relat Res, 2001, (388): 147-156.
7.	Insall JN, Binazzi R, Soudry M, et al. Total knee arthroplasty. Clin Orthop Relat Res, 1985, (192): 13-22.
8.	Hollister AM, Jatana S, Singh AK, et al. The axes of rotation of the knee. Clin Orthop Relat Res, 1993, (290): 259-268.
9.	Yip DK, Zhu YH, Chiu KY, et al. Distal rotational alignment of the Chinese femur and its relevance in total knee arthroplasty. J Arthroplasty, 2004, 19(5): 613-619.
10.	Whiteside LA, Arima J. The anteroposterior axis for femoral rotational alignment in valgus total knee arthroplasty. Clin Orthop Relat Res, 1995, (321): 168-172.
11.	Tashiro Y, Yemura M, Matsuda S, et al. Articular cartilage of the posterior condyle can affect rotational alignment in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2011, 20(8): 1463-1469.
12.	Ries MD, Salehi A, Laskin RS, et al. Can rotational congruity be achieved in both flexion and extension when the femoral component is externally rotated in total knee arthroplasty? Knee, 1998, 5(1): 37-41.
13.	Heesterbeek PJ, Wymenga AB. PCL balancing, an example of the need to couple detailed biomechanical parameters with clinical functional outcome. Knee Surg Sports Traumatol Arthrosc, 2010, 18(10): 1301-1303.
14.	D’Lima DD, Chen PC, Colwell CW Jr. Polyethylene contact stresses, articular congruity, and knee alignment. Clin Orthop Relat Res, 2001, (392): 232-238.
15.	Luyckx L, Luyckx T, Bellemans J, et al. Iliotibial band traction syndrome in guided motion TKA. A new clinical entity after TKA. Acta Orthop Belg, 2010, 76(4): 507-512.

1. Thompson JA, Hast MW, Granger JF, et al. Biomechanical effects of total knee arthroplasty component malrotation: a computational simulation. J Orthop Res, 2011, 29(7): 969-975.
2. Classen T, Wegner A, Müller RD, et al. Femoral component rotation and Laurin angle after total knee arthroplasty. Acta Orthop Belg, 2010, 76(1): 69-73.
3. Berger RA, Rubash HE, Seel MJ, et al. Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res, 1993, (286): 40-47.
4. Churchill DL, Incavo SJ, Johnson CC, et al. The transepicondylar axis approximates the optimal flexion axis of the knee. Clin Orthop Relat Res, 1998, (356): 111-118.
5. Victor J. Rotational alignment of the distal femur: a literature review. Orthop Traumatol Surg Res, 2009, 95(5): 365-372.
6. Akagi M, Yamashita E, Nakagawa T, et al. Relationship between frontal knee alignment and reference axes in the distal femur. Clin Orthop Relat Res, 2001, (388): 147-156.
7. Insall JN, Binazzi R, Soudry M, et al. Total knee arthroplasty. Clin Orthop Relat Res, 1985, (192): 13-22.
8. Hollister AM, Jatana S, Singh AK, et al. The axes of rotation of the knee. Clin Orthop Relat Res, 1993, (290): 259-268.
9. Yip DK, Zhu YH, Chiu KY, et al. Distal rotational alignment of the Chinese femur and its relevance in total knee arthroplasty. J Arthroplasty, 2004, 19(5): 613-619.
10. Whiteside LA, Arima J. The anteroposterior axis for femoral rotational alignment in valgus total knee arthroplasty. Clin Orthop Relat Res, 1995, (321): 168-172.
11. Tashiro Y, Yemura M, Matsuda S, et al. Articular cartilage of the posterior condyle can affect rotational alignment in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2011, 20(8): 1463-1469.
12. Ries MD, Salehi A, Laskin RS, et al. Can rotational congruity be achieved in both flexion and extension when the femoral component is externally rotated in total knee arthroplasty? Knee, 1998, 5(1): 37-41.
13. Heesterbeek PJ, Wymenga AB. PCL balancing, an example of the need to couple detailed biomechanical parameters with clinical functional outcome. Knee Surg Sports Traumatol Arthrosc, 2010, 18(10): 1301-1303.
14. D’Lima DD, Chen PC, Colwell CW Jr. Polyethylene contact stresses, articular congruity, and knee alignment. Clin Orthop Relat Res, 2001, (392): 232-238.
15. Luyckx L, Luyckx T, Bellemans J, et al. Iliotibial band traction syndrome in guided motion TKA. A new clinical entity after TKA. Acta Orthop Belg, 2010, 76(4): 507-512.

Chinese Journal of Reparative and Reconstructive Surgery

IMPACT OF DIFFERENCES OF POSTERIOR CONDYLE CARTILAGE WEAR ON ROTATIONAL POSITIONING OF FEMORAL PROSTHESIS IN TOTAL KNEE ARTHROPLASTY FOR OSTEOARTHRITIS PATIENTS

Abstract Full text Figures/Tables Video References Cited by

Format

Content