The Variability of Femoral Rotational Alignment in Total Knee Arthroplasty

• DOI: 10.2106/jbjs.d.02945
• Publication Date: 2005-10-03T20:07:38Z
• Authors: Robert A. Siston
• Keywords: Cadaveric spasm

Several reference axes are used to establish femoral rotational alignment during total knee arthroplasty, but debate continues with regard which axis is most accurately and easily identified surgery. Computer-assisted navigation systems have been developed in an attempt more consistently align implants it unknown if can improve the accuracy of as compared that achieved traditional techniques involving mechanical guides. The purposes present study were characterize variability associated determine whether use a computer-assisted surgical system reduced this variability.Eleven orthopaedic surgeons five (including one technique four techniques) on ten cadaveric specimens, orientation these was recorded system. These derived against transepicondylar each femur established after complete dissection all soft tissues.There no difference between mean errors (p > 0.11). Only 17% knees rotated <5 degrees from axis, ranging 13 internal rotation 16 external rotation. There significant differences among their ability < 0.001).All resulted highly variable alignment, being superior. This primarily due particular surgeon who performing procedure. A relies directly digitizing epicondyles did not provide reliable means establishing than did.