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Analysis of patellar positioning in the trochlear groove after TKA with and without the use of dynamic tensioner.
It appears that by precisely adjusting femoral component rotation and its relation to soft tissues in the area we can achieve better function of the patellofemoral joint and thus reduce the occurrence of anterior knee pain. Achieving proper femoral component rotation is challenging, as the bony landmarks are difficult to identify. This goal may be accomplished by using a dynamic tensioner - a device that intraoperatively measures joint gap stiffness in extension and 90 degrees flexion. This is especially important in knees with high grade arthritis and limb malalignment, where ligaments' and tendons' efficiency is affected.The aim of this study was to analyze patella positioning in the trochlear groove on CT scans of patients undergoing TKR with use of a dynamic tensioner and compare it to the ones undergoing standard measured-resection technique. Secondary outcome was to assess the frequency of anterior knee pain, range of motion and patient-reported outcome 3 and 12 months after the surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patella positioning after TKR + FUZION | Patients who underwent TKR - femoral component rotation established with a use of a dynamic tensioner (FUZION) |
| |
| Patella positioning after standard TKR | Patients who underwent standard TKR performed with measured resection technique |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Use of dynamic tensioner | Other | Assessment of femoral component rotation with a use of a dynamic tensioner in extension and 90 degrees of flexion. The tensioner was put between tibial plane cut and posterior condyles of the femur and tensioned to the same thickness of insert as in the full extension |
| Measure | Description | Time Frame |
|---|---|---|
| Patella positioning in the trochlear groove on computed tomography (CT) after TKR | Analysis of CT scans of patients undergoing TKR in 30 degrees of knee flexion in the days following the procedure | January 2021 - August 2021 |
| Measure | Description | Time Frame |
|---|---|---|
| Range of motion after TKR | Assessment of range of motion 3 and 12 months after the surgery in the group with standard TKR and dynamic tensioner TKR | January 2021 - January 2022 |
| Patient-reported outcome after TKR |
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Inclusion Criteria:
Exclusion Criteria:
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Consecutive series of patients in age over 60 with 3rd/4th grade of Kellgren - Lawrence osteoarthritis scale.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Othopedics and Rehabilitation, Medical University of Warsaw | Warsaw | Mazovian | 04-749 | Poland |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| D018771 | Arthralgia |
| D007593 | Joint Instability |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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Assessment of patient-reported outcome 3 and 12 months after the surgery in the group with standard TKR and dynamic tensioner TKR
| January 2021 - January 2022 |
| Prevalence of anterior knee pain after TKR | Assessment of the frequency of anterior knee pain 3 and 12 months after the surgery in the group with standard TKR and dynamic tensioner TKR | January 2021 - January 2022 |
| D012216 |
| Rheumatic Diseases |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |