Abstract
Objective: To present our innovative surgical technique that simultaneously provides optimal femorotibial tracking and patellofemoral tracking in total knee arthroplasty.
Material and methods: A total of 127 patients underwent total knee arthroplasty using new criteria for femoral, tibial and patellar preparation and placement of their respective components. The technique consisted of intraoperative determination of the rotation of the femoral and tibial components, lateralization of the femoral and tibial components and medialization of the patellar component, thus reducing the Q-angle. It provided excellent tracking of the tibiofemoral and patellofemoral joints without retinacular release.
Results: At a follow up of up to 3 years, 90% of patients gained up to 120 degrees of motion within first 6 months. Rest pain score [10-0] improved from 5.2 to 0.8. Activity pain score [10-0] improved from 9.0 to 2.0. Stair climbing [0–10] improved from 2.8 to 7.1. Walking score improved from 3.2 to 7.3. ADL function improved from 4.3 to 7.1. Our complications included 1 case of postoperative traumatic fracture of the patella, that healed spontaneously, 1 deep infection which responded well to open lavage, and 6 cases of delayed wound healing that required secondary closure. One patient died of unrelated cause. No fracture, loosening, component failure or instability was recorded. None of the implants required removal.
Conclusion: Implementation of our 10 rules concept of surgical technique gave early excellent results, and we recommend it as a technique universally applicable in total knee arthroplasty.
The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
