Femoral Rotation and Patellar Positioning After TKA

Medical University of Warsaw125 enrolled

Overview

Analysis of patellar positioning in the trochlear groove after TKA with and without the use of dynamic tensioner.

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 Type

OBSERVATIONAL

Enrollment

125

Conditions

Knee Osteoarthritis Joint Pain Joint Instability Patella Disorder Knee Pain Chronic Prosthetic Complication

Interventions

Use of dynamic tensionerOTHER

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

Eligibility

Sex: ALLMin age: 60 YearsMax age: 99 Years

Medical Language ↔ Plain English

Inclusion Criteria: * age over 60 * BMI \< 40 * ablity to walk for 10meters * leg length discrepancy \<5mm * knee flexion \> 90 degrees * hip extension \< 0 degrees * hip flexion \> 90 degrees * III / IV level of osteoarthritis in Kellgren - Lawrence scale Exclusion Criteria: * varus/valgus/ fixed flexion deformity \> 15 degrees * revision TKA * prior UKA

Locations (1)

Department of Othopedics and Rehabilitation, Medical University of Warsaw

Warsaw, Mazovian, Poland

Outcomes

Primary Outcomes

Patella positioning in the trochlear groove on computed tomography (CT) after TKR

Analysis of CT scans of patients undergoing TKR in 30 degrees of knee flexion in the days following the procedure

Time frame: January 2021 - August 2021

Secondary Outcomes

Range of motion after TKR

Assessment of range of motion 3 and 12 months after the surgery in the group with standard TKR and dynamic tensioner TKR

Time frame: January 2021 - January 2022

Patient-reported outcome after TKR

Assessment of patient-reported outcome 3 and 12 months after the surgery in the group with standard TKR and dynamic tensioner TKR

Time frame: January 2021 - January 2022

Prevalence of anterior knee pain after TKR

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

Time frame: January 2021 - January 2022

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.