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Joint line position in revision total knee arthroplasty: the role of posterior femoral off-set stems.
- Source :
-
The Knee [Knee] 2013 Dec; Vol. 20 (6), pp. 447-50. Date of Electronic Publication: 2013 Jun 18. - Publication Year :
- 2013
-
Abstract
- Background: Elevation of the joint line frequently occurs in revision total knee arthroplasty (RTKA) because of a wider flexion space than extension space. One solution to balance this flexion-extension space involves the introduction of couplers between the stem and femoral components, and the use of posteriorly offset femoral stems that we hypothesized would improve gap balancing and facilitate joint line restoration.<br />Methods: We retrospectively reviewed a selected series of 43 RTKA. Postoperative joint line height was subtracted from intended height using postoperative lateral radiographs. The value was negative if the joint line position was lowered, and positive if raised.<br />Results: Forty knees were followed for a mean of 3.5years. Mean postoperative joint line position change from intended position was 1.5mm (range -2.5-7.5mm). In 28 knees (70%), the joint line position was restored to within ±2mm of the intended position; in eight knees (20%), from 2-4mm; and in four knees (10%), >4mm. Joint line position was raised in 32 knees (80%) and lowered in eight (20%). In the offset stem knees, the intended joint line position was 0.9mm (range -1.2-3.4mm) as compared with 3.2mm (range -2.5-7.5mm) for the straight stem knees.<br />Conclusions: A coupler system between the femoral stem and femoral component restored the joint line in 70% of cases. The posterior offset stem provided increased posterior condylar offset, addressed the wider flexion space, provided better positioning of the stem, and restored the joint line.<br />Level of Evidence: Therapeutic Study Level IV.<br /> (Copyright © 2013 Elsevier B.V. All rights reserved.)
- Subjects :
- Aged
Arthroplasty, Replacement, Knee methods
Bone Malalignment surgery
Cohort Studies
Female
Femur Head diagnostic imaging
Femur Head physiopathology
Follow-Up Studies
Humans
Knee Joint diagnostic imaging
Knee Joint physiopathology
Male
Middle Aged
Pain Measurement
Prosthesis Design
Prosthesis Failure
Radiography
Reoperation adverse effects
Reoperation methods
Retrospective Studies
Risk Assessment
Time Factors
Treatment Outcome
Arthroplasty, Replacement, Knee adverse effects
Bone Malalignment etiology
Femur Head surgery
Knee Prosthesis
Range of Motion, Articular physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1873-5800
- Volume :
- 20
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Knee
- Publication Type :
- Academic Journal
- Accession number :
- 23790671
- Full Text :
- https://doi.org/10.1016/j.knee.2013.05.012