Joint Instability, Joint Pain, Knee Osteoarthritis, Knee Pain Chronic, Patella Disorder, Prosthetic Complication
Conditions
Brief summary
Analysis of patellar positioning in the trochlear groove after TKA with and without the use of dynamic tensioner.
Detailed description
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.
Interventions
OTHERUse of dynamic tensioner
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
Sponsors
Medical University of Warsaw
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
60 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* age over 60 * BMI \< 40 * ablity to walk for 10meters * leg length discrepancy \<5mm * knee flexion \> 90 degrees * hip extension \< 0 degrees * hip flexion \> 90 degrees * III / IV level of osteoarthritis in Kellgren - Lawrence scale
Exclusion criteria
* varus/valgus/ fixed flexion deformity \> 15 degrees * revision TKA * prior UKA
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patella positioning in the trochlear groove on computed tomography (CT) after TKR | January 2021 - August 2021 | Analysis of CT scans of patients undergoing TKR in 30 degrees of knee flexion in the days following the procedure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Range of motion after TKR | January 2021 - January 2022 | Assessment of range of motion 3 and 12 months after the surgery in the group with standard TKR and dynamic tensioner TKR |
| Patient-reported outcome after TKR | January 2021 - January 2022 | Assessment of patient-reported outcome 3 and 12 months after the surgery in the group with standard TKR and dynamic tensioner TKR |
| Prevalence of anterior knee pain after TKR | January 2021 - January 2022 | 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 |
Countries
Poland
Outcome results
None listed