Is it possible to re-establish pre-operative patellar kinematics using a ligament-balanced technique in total knee arthroplasty? A cadaveric investigation
Keshmiri, A., Springorum, H., Baier, C. et al.Knee
Purpose
Several authors emphasise that the appearance of patellar maltracking after total knee arthroplasty (TKA) is caused by rotational malalignment of the femoral and tibial components. Ligament-balanced femoral component rotation was not found to be associated with abnormal postoperative patellar position. We hypothesised that a ligament-balanced technique in TKA has the ability to best re-establish patellar kinematics.
Methods
In ten cadaveric knees TKA was performed assessing femoral rotation in ligament-balanced and different femoral and tibial component rotation alignments. Patellar kinematics after different component rotations were analysed using a commercial computer navigation system.
Results
Ligament-balanced femoral rotation showed the best re-establishment of patellar kinematics after TKA compared to the healthy pre-operative knee. In contrast to tibial component rotation, femoral component rotation had a major impact on patellofemoral kinematics.
Conclusions
This investigation suggests that a ligament-balanced technique in TKA is most likely to re-establish natural patellofemoral kinematics. Tibial component rotation did not influence patellar kinematics.
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