Radiographic evaluation of patellofemoral alignment in kinematically aligned total knee arthroplasty: A comparative study with mechanically aligned total knee arthroplasty

Katsuya Nagai, Yasuo Niki, Shu Kobayashi, Kengo Harato, Takeo Nagura, Morio Matsumoto, Masaya Nakamura

研究成果: ジャーナルへの寄稿学術論文査読

6 被引用数 (Scopus)

抄録

Background: Kinematically aligned total knee arthroplasty (KA-TKA), in which femoral component is placed 3–5° of internal rotation relative to mechanically aligned (MA)-TKA, may have a potential risk of patellofemoral malalignment. This study aimed to assess patellofemoral alignment and compare the data between KA-TKA and MA-TKA, and the relationship with patellofemoral radiographic parameters and patient reported outcomes. Methods: Among patients who underwent TKA in 2015 and 2016 in our institute, 28 KA-TKAs with a metal-backed patellar component were retrospectively assessed for patellofemoral alignment, and 28 MA-TKAs with a metal-backed patellar component served as controls. A year postoperatively, patellar tilt and shift at 30°, 60°, and 90° knee flexion were measured on Merchant views and compared between the two TKAs. Implant positioning in each patient was assessed based on preoperative CT images and correlations of femoral component positioning with patellar tilt/shift were assessed. Results: Patellar shift at 30° flexion was significantly greater in KA-TKA than in MA-TKA (p = 0.04), whereas patellar tilt angle was comparable between the two TKAs. No statistical correlation was evident between femoral component positioning and patellar shift/tilt, regardless of knee flexion angle in the two TKAs. Knee Society Score 2011 at 1 year follow-up was comparable in all subcategories between the two TKAs. Conclusion: Radiographic analysis of KA-TKA revealed lateral shift of the patella at 30° knee flexion at 1 year postoperatively, however patients with patellar shift were asymptomatic. Further long-term observation is required to examine the impact of KA-TKA on the patellofemoral complication.

本文言語英語
ページ(範囲)1043-1050
ページ数8
ジャーナルJournal of Orthopaedic Science
26
6
DOI
出版ステータス出版済み - 11-2021
外部発表はい

All Science Journal Classification (ASJC) codes

  • 外科
  • 整形外科およびスポーツ医学

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