Is a femoral component applicator useful in total knee replacement?

The benefit of using an applicator to insert the femoral component during total knee arthroplasty in preventing flexion of the femoral component in the sagittal angle was evaluated in a prospective, consecutive, single-surgeon series. In group I (60 knee replacements) the applicator was used. In group II (64 knees) the femoral component was implanted without an applicator. In all these cases, the femoral cuts were precisely done using cutting blocks. Postoperative X-rays were studied to evaluate the flexion angle of the femoral component in the sagittal plane. Alpha, beta and peg angles of the two groups were compared. It was found that in the group where the applicator was used, there were a slightly higher proportion of patients with values lying within the mean values (two-tailed P value of 0.0009). Our study statistically confirmed that the use of an applicator during femoral component insertion does significantly decrease the incidence of tilt of the femoral component in the sagittal angle.