Kinematic Analysis of the Flexion Axis for Correct Femoral Component Placement

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2011 May 26

PMID 21611781

Citations 7

Authors

Georg Matziolis

Sascha Pfiel

Georgi Wassilew

Hinrich Boenicke

Carsten Perka

Affiliations

Soon will be listed here.

Abstract

Purpose: This study evaluates a new method for intraoperative determination of femoral component rotation by a navigation system (flexion axis, FA) driven by joint stability over the range of motion.

Methods: Seventy-five patients were treated with a navigated total knee replacement. Intraoperatively, the posterior condylar axis (PCA), the Whiteside's line (WL), and the surgical epicondylar axis (EA) were palpated, the flexion gap (FG) was determined, and the FA was calculated. The anatomical landmarks, lines, and angles were determined based on a postoperative computed tomography in all knees. The femoral rotation was intraoperatively determined by the surgeon based on the knowledge of the EA, the PCA, and the FG but not the FA.

Results: The deviation of the palpated EA was 3.5° [0°-13.8°], of the PCA externally rotated by 3° was 2.2° [0°-9.6°], of the WL was 3.8° [0.1°-10.0°], of the FG was 2.5° [0.2°-8.8°], and of the FA was 2.5° [0°-10.0°].

Conclusions: The FA is a new functionally acquired axis for the determination of optimal femoral component alignment. Whether the FA leads to clinically superior results must be clarified by subsequent studies.

Citing Articles

Kinetic Sensors for Ligament Balance and Kinematic Evaluation in Anatomic Bi-Cruciate Stabilized Total Knee Arthroplasty.

Sabatini L, Bosco F, Barberis L, Camazzola D, Bistolfi A, Risitano S Sensors (Basel). 2021; 21(16).

PMID: 34450869 PMC: 8399549. DOI: 10.3390/s21165427.

Kinematic femoral alignment with gap balancing and patient-specific instrumentation in total knee arthroplasty: a randomized clinical trial.

Hommel H, Abdel M, Perka C Eur J Orthop Surg Traumatol. 2016; 27(5):683-688.

PMID: 27714451 DOI: 10.1007/s00590-016-1865-9.

In-vivo analysis of flexion axes of the knee: Femoral condylar motion during dynamic knee flexion.

Feng Y, Tsai T, Li J, Rubash H, Li G, Freiberg A Clin Biomech (Bristol). 2016; 32:102-7.

PMID: 26777272 PMC: 4779404. DOI: 10.1016/j.clinbiomech.2015.12.006.

Alignment in knee flexion position during navigation-assisted total knee arthroplasty.

Yang J, Dahuja A, Kim J, Yun S, Yoon J Knee Surg Sports Traumatol Arthrosc. 2015; 24(8):2422-9.

PMID: 25854497 DOI: 10.1007/s00167-015-3589-5.

How to minimize rotational conflict between femoral & tibial component in total knee arthroplasty: the use of femoro-tibial axial synchronizer (Linker).

Seo J, Moon Y, Kim S, Park S Yonsei Med J. 2015; 56(2):454-9.

PMID: 25683995 PMC: 4329358. DOI: 10.3349/ymj.2015.56.2.454.

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