Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_
Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_ Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_
Poster Topic: Arthroplasty - Knee Abstract number: 24255 TENSOR-BASED DETERMINATION OF ROTATION OF THE FEMORAL COMPONENT INCREASED RANGE OF MOTION OF POSTERIOR-STABILIZED TOTAL KNEE ARTHROPLASTY Seneki KOBAYASHI Suwa Red Cross Hospital, Suwa (JAPAN) A series of 170 primary Optetrak posterior-stabilized total knee arthroplasties in 138 patients were studied to examine effects of changes in surgical techniques on clinical results. The average patient age at operation was 72 years and 78% were in female patients. Knee disease etiology was primary osteoarthrosis in 77%. At the time of operation, all the components were cemented. The rotation of the femoral component was 3 degrees in external rotation with reference to the posterior-condylar line initially (Fixed-rotation Group; 99 knees, 58%). Since 2002, the rotation was determined to get a rectangular gap in 90-degree flexion of the knee using a tensor (Tensor-basedrotation Group; 71 knees). The Knee Society knee and patient-function scores improved significantly after surgery in each group. No case developed impending failure requiring revision. Preoperatively, there were no significant differences in the scores between the groups. Postoperatively, range of motion was statistically significantly larger in the Tensor-based-rotation Group than in the other at 3 months, 6 months, 1 year, 2 years, and the latest follow-up (5.6 years in Fixed-rotation Group, 3.5 years in Tensor-based-rotation Group, on average). The knee score was also significantly better in the Tensor-based-rotation Group than in the other at each follow-up. This study clearly demonstrates the benefits of the tensor-based determination of the rotation of the femoral component that can provide a rectangular flexion gap resulting in an increased range of motion of the knee. 128
Poster Topic: Arthroplasty - Knee Abstract number: 24287 THE INACCURACY OF PROXIMAL TIBIAL ENDOSTEAL REFERENCING IN REVISION TOTAL KNEE REPLACEMENT John EDWIN, Maria SAUNDERS, Jamie ARBUTHNOT, Vipul MANDALIA, Andrew TOMS Royal Devon and Exeter Hospital, Exeter (UNITED KINGDOM) This study investigates the potential for inaccuracies of the proximal tibial cut in performing revision total knee replacement when using endosteal proximal tibial referencing due to the anatomical bowing of the tibia. The electronically stored standardised long leg alignment radiographs taken in the planning process for conversion from primary total or partial knee replacement to stemmed revision knee replacement for 76 knees were analysed. On two separate occasions two independent observers determined the mechanical axis of the tibia and that of the proximal tibia from the mid-point of the tibial plateau to the mid-point of the isthmus. The angle between these axes was measured. The intra-class correlation co-efficient was used to analyse observation variability which was found to be good for intraobserver (0.87) and satisfactory (x) for inter-observer variability. Using the mean observations, the mean difference of proximal tibial endosteal referencing gives a 1.01° (range 0.125 to 3.5) valgus proximal tibial c ut. For 13 of the knees (17%) the angle was >1° and for 6 of the knees (8%) the angle was >2°.Whilst not a source of substantial error alone, we recommend obtaining pre-operative long leg alignment films as a standard investigation prior to revision knee replacement. 129
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Poster<br />
Topic: Arthroplasty - Knee<br />
Abstract number: 24287<br />
THE INACCURACY OF PROXIMAL TIBIAL ENDOSTEAL REFERENCING IN<br />
REVISION TOTAL KNEE REPLACEMENT<br />
John EDWIN, Maria SAUNDERS, Jamie ARBUTHNOT, Vipul MANDALIA, Andrew<br />
TOMS<br />
Royal Devon and Exeter Hospital, Exeter (UNITED KINGDOM)<br />
This study investigates the potential for inaccuracies of the proximal tibial cut in<br />
performing revision total knee replacement when using endosteal proximal tibial<br />
referencing due to the anatomical bowing of the tibia. The electronically stored<br />
standardised long leg alignment radiographs taken in the planning process for<br />
conversion from primary total or partial knee replacement to stemmed revision knee<br />
replacement for 76 knees were analysed. On two separate occasions two<br />
independent observers determined the mechanical axis of the tibia and that of the<br />
proximal tibia from the mid-point of the tibial plateau to the mid-point of the isthmus.<br />
The angle between these axes was measured. The intra-class correlation co-efficient<br />
was used to analyse observation variability which was found to be good for intraobserver<br />
(0.87) and satisfactory (x) for inter-observer variability. Using the mean<br />
observations, the mean difference of proximal tibial endosteal referencing gives a<br />
1.01° (range 0.125 to 3.5) valgus proximal tibial c ut. For 13 of the knees (17%) the<br />
angle was >1° and for 6 of the knees (8%) the angle was >2°.Whilst not a source of<br />
substantial error alone, we recommend obtaining pre-operative long leg alignment<br />
films as a standard investigation prior to revision knee replacement.<br />
129
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