Femoral Rotation and Patellar Positioning After TKA
Study Details
Study Description
Brief Summary
Analysis of patellar positioning in the trochlear groove after TKA with and without the use of dynamic tensioner.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
It appears that by precisely adjusting femoral component rotation and its relation to soft tissues in the area we can achieve better function of the patellofemoral joint and thus reduce the occurrence of anterior knee pain. Achieving proper femoral component rotation is challenging, as the bony landmarks are difficult to identify. This goal may be accomplished by using a dynamic tensioner - a device that intraoperatively measures joint gap stiffness in extension and 90 degrees flexion. This is especially important in knees with high grade arthritis and limb malalignment, where ligaments' and tendons' efficiency is affected.The aim of this study was to analyze patella positioning in the trochlear groove on CT scans of patients undergoing TKR with use of a dynamic tensioner and compare it to the ones undergoing standard measured-resection technique. Secondary outcome was to assess the frequency of anterior knee pain, range of motion and patient-reported outcome 3 and 12 months after the surgery.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Patella positioning after TKR + FUZION Patients who underwent TKR - femoral component rotation established with a use of a dynamic tensioner (FUZION) |
Other: Use of dynamic tensioner
Assessment of femoral component rotation with a use of a dynamic tensioner in extension and 90 degrees of flexion. The tensioner was put between tibial plane cut and posterior condyles of the femur and tensioned to the same thickness of insert as in the full extension
|
| Patella positioning after standard TKR Patients who underwent standard TKR performed with measured resection technique |
Outcome Measures
Primary Outcome Measures
- Patella positioning in the trochlear groove on computed tomography (CT) after TKR [January 2021 - August 2021]
Analysis of CT scans of patients undergoing TKR in 30 degrees of knee flexion in the days following the procedure
Secondary Outcome Measures
- Range of motion after TKR [January 2021 - January 2022]
Assessment of range of motion 3 and 12 months after the surgery in the group with standard TKR and dynamic tensioner TKR
- Patient-reported outcome after TKR [January 2021 - January 2022]
Assessment of patient-reported outcome 3 and 12 months after the surgery in the group with standard TKR and dynamic tensioner TKR
- Prevalence of anterior knee pain after TKR [January 2021 - January 2022]
Assessment of the frequency of anterior knee pain 3 and 12 months after the surgery in the group with standard TKR and dynamic tensioner TKR
Eligibility Criteria
Criteria
Inclusion Criteria:
-
age over 60
-
BMI < 40
-
ablity to walk for 10meters
-
leg length discrepancy <5mm
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knee flexion > 90 degrees
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hip extension < 0 degrees
-
hip flexion > 90 degrees
-
III / IV level of osteoarthritis in Kellgren - Lawrence scale
Exclusion Criteria:
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varus/valgus/ fixed flexion deformity > 15 degrees
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revision TKA
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prior UKA
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Department of Othopedics and Rehabilitation, Medical University of Warsaw | Warsaw | Mazovian | Poland | 04-749 |
Sponsors and Collaborators
- Medical University of Warsaw
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- WarsawMU/FRPP