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Computed tomography evaluation of total knee arthroplasty implants position after two different surgical methods of implantation

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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.

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Authors and Affiliations

  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

    Francesco Benazzo, Stefano Marco Paolo Rossi, Simone Perelli & Matteo Ghiara

  2. Interventional and Diagnostic Radiology and Neuroradiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Gianmarco Danesino

  3. Clinical Epidemiology and Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Catherine Klersy

Authors
  1. Francesco Benazzo
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  2. Stefano Marco Paolo Rossi
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  3. Gianmarco Danesino
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  4. Catherine Klersy
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  5. Simone Perelli
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  6. Matteo Ghiara
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Corresponding author

Correspondence to Matteo Ghiara.

Ethics declarations

Ethical committee approval was obtained for this study (protocol number 20150003437).

Conflict of interest

The first Author (FB) is part of the design team of the implant. The other authors (MG, GD, CK, SMPR, and SP) declare that they have no conflict of interest. The study is a spontaneous observational investigation carried out by the Authors.

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Benazzo, F., Rossi, S.M.P., Danesino, G. et al. Computed tomography evaluation of total knee arthroplasty implants position after two different surgical methods of implantation. International Orthopaedics (SICOT) 43, 139–149 (2019). https://doi.org/10.1007/s00264-018-4180-8

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  • DOI: https://doi.org/10.1007/s00264-018-4180-8

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