Rotational Alignment of Femoal Component — Radiological Evaluation
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概要
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Objective : We radiologically studied the validity of bone cutting and postoperative soft tissue conditions in excessive external rotation of the femoral component modulated by the balanced gap technique in total knee arthroplasty.<BR>Methods : The study was conducted on 34 cases in which the femoral component was externally rotated 1 degree over the clinical epicondylar axis, defined as the excessive external rotation group (E group), and 67 cases in which components were internally rotated between 1°and 5°from the clinical epicondylar axis, defined as the control group (C group) . Varus and valgus instability and the α βγδangles of the Knee Society roentgenographic evaluation for the validity of operation, preoperative condylar twist angle, external rotation degree of the femoral component, symmetry of the flexion gap on the trans-epicondylar view, patella tilting on the skyline view, and postoperative flexion of the knee were investigated.<BR>Results : The preoperative condylar twist angle was significantly smaller in the E group (5.3±1.8°) than in the C group (7.8±2.3°) . The external rotation angle of the femoral component was significantly larger in the group (7.7±1.9°) than in the C group (5.4±2.4°) . No significant differences were seen between the two groups in patella tilting or postoperative flexion angle. The flexion gap in E group was significantly closer to rectangular than in the C group.<BR>Conclusion : Our results suggest that a small CTA may lead to excessive external rotation of the femoral component by the balanced gap technique. Such cases demonstrate satisfactory soft tissue balance, ROM, and patella tracking without complications.
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