Alignment analysis of TKA
Marquez Gomez, Armando |
Recenzentas / Reviewer | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member |
Knee arthroplasties are becoming one of the most common surgical procedures on the last decades. Many researches have been made in order to understand why postoperative alignment after a total knee arthroplasty is important and which factors are the ones affecting such alignment. Postoperative neutral mechanical axis alignment has been shown to affect the implant survival, the revision rate and the function of knee arthroplasties. Many factors have been suggested to affect the mechanical axis, from which the most important are the individual component alignment. In our study we wanted to check these factors, their distribution among the patients undergoing TKA and how each of them was related with the MA alignment. We included tibial and femoral component and two femoral anatomical angles which are known to have wide variations among population: the femoral bowing angle (FBA) and the Caput-Collum-Diaphyseal angle (CCD). For our study we retrospectively evaluated radiographs from 255 consecutive patients undergoing TKA. From those patients 123 would pass our inclusion and exclusion criteria and form part of our research population. We evaluated the distribution of the different factors (MA, TC, FC, FBA and CCD) and distributed them into normally aligned or outliers and the correlation they had with one another. The most common operative failure we found was the femoral component positioning which had an outlier rate of 22.8% and a big correlation with the MA alignment (p=0.000). Similar findings were found regarding the tibial component. With a decreased outlier rate (14.6%) and a high correlation with the MA alignment (p=0.002). The femoral anatomical angles didn’t show any correlation with any of the other factors, although FBA was slightly different among genders with the female average of 3.3° and 1.5° for males (p= 0.33). We concluded that surgeons should have a greater concern on the proper alignment of the femoral component, for it is the most common operative failure in TKA surgeries. We found that age plays a small role in MA alignment, although is not statistically significant. Femoral and tibial component proper alignment are crucial for good results after TKA, and femoral anatomical angles do not play a role in the overall MA alignment.
Darbo tikslas: Išanalizuoti šlaunikaulio anatominius ir kelio sąnario endoprotezo komponentų kampus ir įvertinti jų ryšį su pooperacine mechanine kojos ašimi.
Darbo uždaviniai:
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Išanalizuoti kelio sąnario endoprotezo komponentų padėtį endoprotezavimo operacijos. -
Įvertinti amžiaus įtaką kojos mechaninei ašiai po kelio sąnario endoprotezavimo operacijų. -
Įvertinti komponentų padėities įtaką kojos mechaninei ašiai po kelio sąnario endoprotezavimo operacijų. -
Ištirti šlaunikaulio išlinkimo kampo ir šlaunikaulio kaklo kūno ašių kampo įtaką kojos mechaninei ašiai po kelio sąnario endoprotezavimo operacijų
Išvados:
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Įvertinus kelio sąnario endoprotezo komponentų padėtį, nustatyta, kad šlaunikaulionio komponento varus padėtis dominuoja netiklsios implantacijos atvejais. -
Amžius neįtakojo kojos mechaninės ašies po kelio sąnario endoprotezavimo operacijų. -
Šlaunikaulinio ir blauzdikaulinio komponentų padėtys įtakojo kojos mechaninę ašį po kelio sąnario endoprotezavimo operacijų. -
Šlaunikaulio išlinkimo ir šlaunikaulio kaklo kūno ašių kampai reikšmingai neįtakojo kojos mechaninės ašies po kelio sąnario endoprotezavimo operacijų.