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Internal Rotation Of The Tibial Component Is Frequent In Stiff Total Knee Arthroplasty

M. Bédard, K. Vince, J. Redfern, S. Collen
Published 2011 · Medicine

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BackgroundStiffness complicating TKA is a complex and multifactorial problem. We suspected internally rotated components compromised motion because of pain, patellar maltracking, a tight medial flexion gap, and limited femoral rollback on a conforming lateral tibial condyle.Questions/purposesWe sought to determine: (1) the incidence of internal rotation of the femoral and tibial components in stiff TKAs; (2) if revision surgery that included correction of rotational positioning improved pain, ROM, and patellar tracking; and (3) if revision altered nonrotational radiographic parameters.MethodsFrom a cohort of 52 patients with TKAs revised for stiffness, we performed CT scans of 34 before and 18 after revision to quantify rotational positioning of the femoral and tibial components using a previously validated scanning protocol.ResultsAll 34 patients with TKAs had internal rotation of the summed values for tibial and femoral components (mean, 14.8°; range, 2.7°–33.7°) before revision for stiffness. The incidence of internal rotation was 24 of 34 femoral (mean, 3.1°; internal) and 33 of 34 tibial components (mean, 13.7° internal). Revision arthroplasty improved Knee Society function, knee, and pain scores. Mean extension improved from a contracture of 10.1° to 0.8° and flexion from 71.5° to 100°. Postrevision CT scans confirmed correction of component rotation. Nonrotational parameters were unchanged.ConclusionsWe recommend CT scanning of patients with stiff TKAs before surgical intervention to identify the presence of internally rotated components.Level of EvidenceLevel IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
This paper references
10.1148/101.1.101
Patella position in the normal knee joint.
J. Insall (1971)
10.2106/00004623-197153080-00011
A midline approach to the knee.
J. Insall (1971)
10.1097/00003086-197210000-00012
Recurrent dislocation and the high-riding patella.
J. Insall (1972)
10.2106/00004623-197456070-00007
Roentgenographic analysis of patellofemoral congruence.
A. C. Merchant (1974)
10.2106/00004623-198567090-00003
Patellar dislocation following total knee replacement.
R. Merkow (1985)
10.1097/00003086-198911000-00004
Rationale of the Knee Society clinical rating system.
J. Insall (1989)
10.3928/0147-7447-19900601-08
Factors affecting postoperative flexion in total knee arthroplasty.
H. Shoji (1990)
Knee manipulation following total knee arthroplasty. Analysis of prognostic variables.
D. Daluga (1991)
10.1016/S0883-5403(11)80006-9
Knee manipulation following total knee arthroplasty
D. Daluga (1991)
10.1016/S0030-5898(20)31781-8
The patella in total knee arthroplasty.
K. Vince (1992)
10.1097/00003086-199301000-00016
Patellar tilt and subluxation in total knee arthroplasty. Relationship to pain, fixation, and design.
D. F. Bindelglass (1993)
10.1097/00003086-199301000-00008
Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis.
R. Berger (1993)
10.3109/17453679408995475
The Swedish knee arthroplasty register. A nation-wide study of 30,003 knees 1976-1992.
K. Knutson (1994)
10.2106/00004623-199401000-00006
Prophylaxis against infection in total joint arthroplasty. One day of cefuroxime compared with three days of cefazolin.
D. Mauerhan (1994)
Patellar thickness in total knee replacement.
C. C. Jiang (1994)
The Stiff TKA
K Vince (1994)
10.1097/00003086-199610000-00026
Arthroscopic Release of the Posterior Cruciate Ligament for Stiff Total Knee Arthroplasty
Riley J. Williams* (1996)
10.1016/S0883-5403(96)80101-X
Patellar tilt and subluxation following subvastus and parapatellar approach in total knee arthroplasty. Implication for surgical technique.
D. F. Bindelglass (1996)
10.1097/00003086-199811000-00021
Malrotation Causing Patellofemoral Complications After Total Knee Arthroplasty
R. Berger (1998)
10.2106/00004623-199910000-00011
Sample size and statistical power in clinical orthopaedic research.
K. Freedman (1999)
10.1054/ARTH.2000.8193
The accuracy of computed tomography for determining femoral and tibial total knee arthroplasty component rotation.
L. Jazrawi (2000)
10.3928/0147-7447-20000901-31
The stiff knee: causes and cures.
W. N. Scott (2000)
10.1097/00003086-200011000-00024
Arthrofibrosis After Total Knee Arthroplasty
M. Ries (2000)
10.3928/0147-7447-20010901-36
The stiff total knee arthroplasty: causes and cures.
D. Dennis (2001)
10.1054/ARTH.2001.22250
Management of knee pain and stiffness after total knee arthroplasty.
P. Scranton (2001)
10.1097/00003086-200111000-00006
Component Rotation and Anterior Knee Pain After Total Knee Arthroplasty
R. Barrack (2001)
10.2106/00004623-200110000-00012
Poor Outcomes of Isolated Tibial Insert Exchange and Arthrolysis for the Management of Stiffness Following Total Knee Arthroplasty
G. Babis (2001)
10.1097/00003086-200108000-00011
Patella in total knee arthroplasty.
R. Barrack (2001)
10.1054/ARTH.2002.32105
Revision of the stiff total knee arthroplasty.
C. Christensen (2002)
10.2106/00004623-200307000-00014
Predicting Range of Motion After Total Knee Arthroplasty: Clustering, Log-Linear Regression, and Regression Tree Analysis
M. Ritter (2003)
10.1302/0301-620X.85B4.13749
The results of revision knee arthroplasty with and without retention of secure cemented femoral components.
D. Mackay (2003)
10.1016/S0883-5403(03)00448-0
The value of white blood cell counts before revision total knee arthroplasty.
J. B. Mason (2003)
10.5435/00124635-200309000-00009
The Unstable Patella After Total Knee Arthroplasty: Etiology, Prevention, and Management
M. Malo (2003)
10.5435/00124635-200405000-00004
Stiffness After Total Knee Arthroplasty
M. Bong (2004)
10.1016/J.ARTH.2003.12.084
Results of revision total knee arthroplasty after exposure of the knee with extensor mechanism tenolysis.
P. Sharkey (2004)
10.1016/J.ARTH.2003.11.001
Predicting range of motion after revision total knee arthroplasty: clustering and log-linear regression analyses.
M. Ritter (2004)
10.1016/J.ARTH.2004.02.008
Stiffness after total knee arthroplasty.
R. Laskin (2004)
10.2214/AJR.182.2.1820337
Arthrofibrosis associated with total knee arthroplasty: gray-scale and power Doppler sonographic findings.
J. Boldt (2004)
10.2106/00004623-200407000-00017
Stiffness after total knee arthroplasty. Prevalence of the complication and outcomes of revision.
Jane Kim (2004)
10.1302/0301-620X.86B7.15255
Multiple congenital brachymetatarsia. A one-stage combined shortening and lengthening procedure without iliac bone graft.
J. Kim (2004)
10.1097/01.blo.0000186560.70566.dc
Outcome Comparison of Partial and Full Component Revision TKA
T. Fehring (2005)
10.1016/J.ARTH.2005.03.014
The stiff total knee arthroplasty: causality and solution.
G. Scuderi (2005)
10.2106/00004623-200509001-00009
Stiffness After Total Knee Arthroplasty: Surgical Technique
C. Nelson (2005)
10.1016/J.ARTH.2004.09.057
Functional results after revision of well-fixed components for stiffness after primary total knee arthroplasty.
G. Haidukewych (2005)
10.3928/0147-7447-20050901-43
A step-wise approach to revision TKA.
K. Vince (2005)
10.1302/0301-620X.87B10.16228
Results of open arthrolysis for the treatment of stiffness after total knee replacement.
J. Hutchinson (2005)
10.1007/s00264-006-0085-z
Femoral component rotation and arthrofibrosis following mobile-bearing total knee arthroplasty
J. Boldt (2006)
10.1016/J.KNEE.2005.10.001
Stiffness after total knee arthroplasty: prevalence, management and outcomes.
H. Yercan (2006)
10.1016/J.ARTH.2005.09.012
Reproducibility of measurement of femoral component rotation after total knee arthroplasty using computer tomography.
T. Suter (2006)
10.1016/J.ARTH.2005.06.004
Predictive risk factors for stiff knees in total knee arthroplasty.
R. Gandhi (2006)
10.2106/JBJS.F.00608
Management of stiffness following total knee arthroplasty.
J. Parvizi (2006)
10.1097/BLO.0b013e3180332d97
Early Revision for Component Malrotation in Total Knee Arthroplasty
S. Incavo (2007)
Implanting the Revision Total Knee Arthroplasty
K Vince (2008)



This paper is referenced by
10.1007/s00264-021-05023-3
Causes of stiffness after total knee arthroplasty: a systematic review
S. Zaffagnini (2021)
10.1007/s00167-021-06495-x
Computer-assisted surgery and patient-specific instrumentation improve the accuracy of tibial baseplate rotation in total knee arthroplasty compared to conventional instrumentation: a systematic review and meta-analysis
R. Tandogan (2021)
10.1007/978-3-030-57578-6_22
Morphometric Analysis of the Knee: A Comprehensive Evaluation of Knee Morphology in Designing Arthroplasties of Knee
Mohamed Elfekky (2021)
10.1016/j.artd.2021.01.016
Single-Sided Reciprocating Saw for Tibial Component Removal During Revision Total Knee Arthroplasty
Rohan Gopinath (2021)
10.1111/os.12895
Early Patellofemoral Function of Medial Pivot Prostheses Compared with Posterior‐Stabilized Prostheses for Unilateral Total Knee Arthroplasty
Z. Wang (2021)
10.1007/978-3-030-44492-1_15
The Stiff Total Knee Arthroplasty
E. C. Rodriguez-Merchan (2020)
10.1007/978-3-030-44492-1
Comprehensive Treatment of Knee Osteoarthritis: Recent Advances
C. Rodríguez-Merchán (2020)
10.1007/s00167-020-05864-2
Malrotation of the fixed-bearing posterior stabilized total knee prosthesis causes a postoperative rotational mismatch between the femur and tibia
Hideki Ueyama (2020)
10.1007/s00167-020-05875-z
Total knee arthroplasty: posterior tibial slope influences the size but not the rotational alignment of the tibial component
P. Ismailidis (2020)
10.1038/s41598-020-67613-2
Approximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation
Long Shao (2020)
10.1016/j.jmbbm.2019.103564
Impact of tibial baseplate malposition on kinematics, contact forces and ligament tensions in TKA: A numerical analysis.
A. Fottner (2020)
10.1007/s00402-020-03340-7
Optimal rotational positioning of tibial component in total knee arthroplasty: determined by linker surgical technique using a high definition CT
Woon-Hwa Jung (2020)
10.1503/CJS.001617
Understanding the patellofemoral joint in total knee arthroplasty
Jacob Matz (2019)
10.1016/j.arth.2019.05.058
Intraoperative Tibial Anteroposterior Axis Could Not Be Replicated After Tibial Osteotomy in Total Knee Arthroplasty.
K. Kawaguchi (2019)
10.1016/j.jor.2018.11.005
The usefulness of planning using a preoperative lateral leg image to determine accurate posterior tibial slope in total knee arthroplasty.
T. Tomite (2019)
10.1007/s00167-019-05695-w
Internal rotation of the tibial component in total knee arthroplasty can lead to extension deficit
M. K. Abdelnasser (2019)
10.1016/j.artd.2018.07.008
Computed tomography confirmation of component rotation in nanosensor-balanced total knee arthroplasty
Jacob Riis (2019)
10.1007/s00402-019-03221-8
Posterior condylar resections in total knee arthroplasty: current standard instruments do not restore femoral condylar anatomy
Nina Wuertele (2019)
10.1016/j.arth.2019.02.007
Improved Range of Motion and Patient-Reported Outcome Scores With Fixed-Bearing Revision Total Knee Arthroplasty for Suboptimal Axial Implant Rotation.
D. Amanatullah (2019)
10.1007/s00590-019-02423-5
Rotational component alignment in patient-specific total knee arthroplasty compared with conventional cutting instrument
Nuttawut Chanalithichai (2019)
10.1302/2058-5241.4.180105
The stiff total knee arthroplasty: causes, treatment modalities and results
E. Rodriguez-Merchan (2019)
10.1016/j.knee.2018.09.002
A new landmark for measuring tibial component rotation after total knee arthroplasty.
F. Mahmood (2019)
10.1016/j.arth.2018.10.022
Measuring Tibial Component Rotation Following Total Knee Arthroplasty: What Is the Best Method?
M. Saffi (2019)
10.1007/s00264-018-4180-8
Computed tomography evaluation of total knee arthroplasty implants position after two different surgical methods of implantation
F. Benazzo (2018)
10.1016/j.arth.2018.02.009
Extrinsic Factors as Component Positions to Bone and Intrinsic Factors Affecting Postoperative Rotational Limb Alignment in Total Knee Arthroplasty.
T. Mochizuki (2018)
10.1371/journal.pone.0209317
A proposed new rotating reference axis for the tibial component after proximal tibial resection in total knee arthroplasty
T. Ohmori (2018)
Coronal Instability after Total Knee Arthroplasty using Bi-Surface type 3 : An Averaged 10 Year Follow-up Study
Kim Mindae (2018)
10.24645/JEJOT.30.2_155
Ahlbäck分類4-5の内側型変形性膝関節症に対する膝周囲骨切り術とtotal knee arthroplastyの短期臨床成績の比較
齊藤 英知 (2018)
10.1055/s-0038-1676564
Effect of Tibial Component Alignment and Posterior Slope on Tibial Coverage in a Chinese Population: A Three-dimensional Anthropometric Study.
Long Shao (2018)
10.1136/jisakos-2018-000214
Multiple reference axes should be used to improve tibial component rotational alignment: a meta-analysis
K. Valkering (2018)
10.21037/atm.2018.02.15
Total knee replacement modifies the preoperative tibial torsion angle-similar results between computer-assisted and standard technique.
D. Hernandez-Vaquero (2018)
10.1007/s00402-018-3073-z
Suboptimal patellofemoral alignment is associated with poor clinical outcome scores after primary total knee arthroplasty
R. Narkbunnam (2018)
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