A prospective study of functional outcome and rotational alignment of femoral component in unnavigated total knee arthroplasty.

Senthil, P (2014) A prospective study of functional outcome and rotational alignment of femoral component in unnavigated total knee arthroplasty. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.


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INTRODUCTION: Arthritis is the most common disabling disease that affects millions of people in our country. The common causes of knee arthritis include Osteoarthritis (OA), Rheumatoid Arthritis (RA), Juvenile Rheumatoid Arthritis, Post traumatic Arthritis, Secondary Osteoarthritis and other types of inflammatory arthritis. The incidence of osteoarthritis is increasing with increase in ageing population. The surgical management of Osteoarthritis varies from soft tissue interposition arthroplasty to surface replacement arthroplasty. In surface replacement arthroplasty different types of prosthesis were developed to address the complex kinematics of the knee joint. Various systems are available with specific features regarding the geometry of the components, the degree of conformity of the articulating surface and the anchoring technique. Various implant designs such as cruciate substituting and cruciate retaining prosthesis are available to improve the functional outcome. The purpose of the study is to prospectively study the functional outcome and rotational alignment of femoral component in unnavigated Total Knee Arthroplasty. MATERIALS AND METHODS: In our study 20 cases of arthritis knee treated with cemented Total Knee Arthroplasty. Both cruciate retaining and cruciate substituting prosthesis were used. Out of 20 cases 12 were males and 8 females, left side is more commonly involved than right side. The outcome was measured using the knee society scoring system at 6months and 1 year. The Knee Society Scoring system is subdivided in to a knee score that rates only the knee joint itself and a functional score that rates the patient’s ability to walk and climb stairs. Post operatively the rotational alignment of the femoral component was measured by an angle formed between the transepicondylar axis and posterior codylar line of the prosthesis in two dimensional CTscan. RESULTS: In our study there is significant improvement in knee society scoring system post operatively. The rotational alignment of the femoral component ranges between 4.1 degrees to 11 degrees of external rotation. The average post operative Knee Clinical Score was 91.6. The average post operative Knee Functional Score was 86. In our study out of 20 cases anterior knee pain was noted in 6 cases, superficial infection in 2 cases which was treated with culture sensitive antibiotics and notching of anterior femoral cortex in 1 case. CONCLUSION: Total Knee Arthroplasty improves the functional ability of the patient and the ability of the patient to get back to pre-disease state, which is to have a pain free mobile joint, as reflected by the improvement in the post-op Knee Clinical Score and Knee Functional Score. It is possible to achieve the rotational alignment of the components correctly in unnavigated Total Knee Replacement with appropriate surgical techniques, so that the complications due to malalingment of the components can be avoided.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Arthritis, cruciate retaining prosthesis, cruciate substituting prosthesis, knee society scoring system, transepicondylar axis, posterior condylar line, rotational alignment.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 21 Sep 2017 02:11
Last Modified: 21 Sep 2017 02:11
URI: http://repository-tnmgrmu.ac.in/id/eprint/3029

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