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Distal femoral resection at knee replacement - the effect of varying entry point and rotation on prosthesis position.

Abstract
Malalignment may contribute to early prosthesis failure through point loading and premature polyethylene wear. Femoral resection requires for distal planar resection contingent upon correct rotation and coronal alignment. Using a standard model, we have examined the influence of differing femoral entry points and rotations upon final femoral component positioning. A graphical method and navigation system independently quantified the individual and combined impact of these variables, in 3 planes. Nine permutations were assessed with reference to neutral rotation and a central entry point. The graphical results were corroborated by the navigation analyses. We found that external rotation and a superolateral entry point introduced the greatest error in final component positioning. We have identified a safe envelope for femoral rod positioning and recommend that the rotational alignment is determined before distal bone resection.
AuthorsRajkumar Gangadharan, David J Deehan, Andrew W McCaskie
JournalThe Knee (Knee) Vol. 17 Issue 5 Pg. 345-9 (Oct 2010) ISSN: 1873-5800 [Electronic] Netherlands
PMID19875296 (Publication Type: Journal Article)
CopyrightCopyright 2009 Elsevier B.V. All rights reserved.
Topics
  • Arthrometry, Articular
  • Arthroplasty, Replacement, Knee (methods)
  • Biomechanical Phenomena
  • Computer Simulation
  • Femur (surgery)
  • Humans
  • Knee Prosthesis
  • Models, Anatomic
  • Prosthesis Design
  • Prosthesis Failure
  • Rotation
  • Surgery, Computer-Assisted (methods)

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