No influence of femoral component rotation by the lateral femoral posterior condylar cartilage remnant technique on clinical outcomes in navigation-assisted TKA

Seong Hwan Kim, Yong-Beom Park, Dae Woong Ham, Jae-Sung Lee, Min-Ku Song, Han-Jun Lee
Knee Surgery, Sports Traumatology, Arthroscopy 2017, 25 (11): 3576-3584

PURPOSE: To investigate whether cartilage thickness in the lateral femoral posterior condyle affects the femoral rotation angles on navigation and clinical outcomes of navigation-assisted total knee arthroplasty (TKA).

METHODS: This is a prospective randomized study of navigation-assisted TKA. Fifty cases underwent TKA without removal of the lateral posterior femoral cartilage (Group 1), and 56 cases underwent TKA with removal of the lateral posterior femoral cartilage (Group 2). The femoral rotation was evaluated using CT and compared with navigation values. The angle between the clinical transepicondylar axis and posterior condylar axis measured on CT was defined as the femoral rotation angle on CT. Elevation of the joint line and patellar measurements were also evaluated.

RESULTS: The clinical outcomes were not statistically different in the two groups. The radiographic measurements were not statistically different except femoral rotation angle on navigation. The mean femoral rotation angle of navigation was 4.0° ± 2.2° without cartilage removal and 5.1° ± 2.5° with cartilage removal. The reliability and validity were high between the femoral rotation angle on navigation in the cartilage removal group and that on CT, but there were no differences in clinical outcomes between the two groups.

CONCLUSION: There was little effect of navigation-assisted TKA on radiographic and clinical outcomes, although femoral rotational differences were caused by the lateral femoral posterior condylar cartilage. Although the rotational differences due to cartilage would be within the clinical safety margin, surgeons should consider that difference during TKA.

LEVEL OF EVIDENCE: Lower quality randomized trial (no masking), Level II.

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