Francesco Benazzo1, Stefano Marco Paolo Rossi1, Gianmarco Danesino2, Catherine Klersy3, Simone Perelli1, Matteo Ghiara4. 1. Department of Clinical-Surgical Sciences, Diagnostics and Pediatrics, University of Pavia, Operative Unit of Orthopaedics and Traumatology, Fondazione IRCCS Policlinico San Matteo, Via Golgi, 19, 27100, Pavia, Italy. 2. Interventional and Diagnostic Radiology and Neuroradiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. 3. Clinical Epidemiology and Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. 4. Department of Clinical-Surgical Sciences, Diagnostics and Pediatrics, University of Pavia, Operative Unit of Orthopaedics and Traumatology, Fondazione IRCCS Policlinico San Matteo, Via Golgi, 19, 27100, Pavia, Italy. ghiaram@libero.it.
Abstract
PURPOSE: The objectives of this study were to determine the reliability of a novel method of measuring the rotational alignment of an anatomical tibial tray, the difference in the rotational alignment of the femoral and tibial component according to pure measured resection or blended technique with tensor, and, finally, the difference in terms of clinical results according to the two different methods. PATIENTS AND METHODS: We performed a total of 60 consecutive TKAs: 30 according to pure measured resection and 30 according to blended technique with tensor (FuZion®). Clinical scores and CT scan were done at six months to measure patient's outcome and prosthetic components rotation. RESULTS: The method of measurement of tibial tray had high agreement between different radiological observers. Mean external rotation alignment of the femur was 2.7° in standard group and 0.5° in the FuZion® group. For all clinical indices, we observed a large and significant improvement at follow-up, better in blended technique group, but without a clear superiority, and no statistically significant difference was evident between the two groups. At follow-up, HSS was to 89.7 in the FuZion® group and 89.0 in the standard group, KSS (clinical) was 92.6 in and 91.3 respectively, and KSS (Functional) was 91.0 in the FuZion® group and 87.6 in the standard group. CONCLUSIONS: Our CT measurement method is reliable and reproducible. All patients operated with this personalized knee system design obtained excellent results; the customization of femoral rotation with a blended technique is, probably, the key to optimize the outcomes and achieve the state of forgotten knee.
PURPOSE: The objectives of this study were to determine the reliability of a novel method of measuring the rotational alignment of an anatomical tibial tray, the difference in the rotational alignment of the femoral and tibial component according to pure measured resection or blended technique with tensor, and, finally, the difference in terms of clinical results according to the two different methods. PATIENTS AND METHODS: We performed a total of 60 consecutive TKAs: 30 according to pure measured resection and 30 according to blended technique with tensor (FuZion®). Clinical scores and CT scan were done at six months to measure patient's outcome and prosthetic components rotation. RESULTS: The method of measurement of tibial tray had high agreement between different radiological observers. Mean external rotation alignment of the femur was 2.7° in standard group and 0.5° in the FuZion® group. For all clinical indices, we observed a large and significant improvement at follow-up, better in blended technique group, but without a clear superiority, and no statistically significant difference was evident between the two groups. At follow-up, HSS was to 89.7 in the FuZion® group and 89.0 in the standard group, KSS (clinical) was 92.6 in and 91.3 respectively, and KSS (Functional) was 91.0 in the FuZion® group and 87.6 in the standard group. CONCLUSIONS: Our CT measurement method is reliable and reproducible. All patients operated with this personalized knee system design obtained excellent results; the customization of femoral rotation with a blended technique is, probably, the key to optimize the outcomes and achieve the state of forgotten knee.
Entities:
Keywords:
Blended technique with tensor; CT measurement TKA rotation; Measured resection and gap balancing; Personalized TKA design