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Volume 3, Issue 4 (Suppl)
J Clin Exp Orthop
ISSN:2471-8416
Osteoporosis and Arthroplasty 2017
December 04-05, 2017
Page 33
&
11
th
International Conference on
Joint Event
OSTEOPOROSIS, ARTHRITIS & MUSCULOSKELETAL DISORDERS
December 04-05, 2017 | Madrid, Spain
10
th
INTERNATIONAL CONFERENCE ON ARTHROPLASTY
E Krishna Kiran, J Clin Exp Orthop 2017, 3:4(Suppl)
DOI: 10.4172/2471-8416-C1-001
The relationship of the posterior condylar axis and Whiteside’s axis in various osteoarthritic Indian
knees undergoing primary total knee arthroplasty: A computer navigation based study
Aim:
In varus osteoarthritic knees using Computer Assisted Surgery (CAS), assess the correlation between the degree of
preoperative varus deformity, both in extension and in flexion, and the degree of external rotation required to align the femoral
component with Whiteside’s axis.
Material & Methods:
This was a single centre computer navigation based study of 106 consecutive Indian varus osteoarthritic
knees undergoing primary Total Knee Arthroplasty(TKA). The angle of rotation between the Posterior Condylar Axis (PCA)
and Whiteside’s line was calculated using CAS and the measured external rotation was set using the 4-in-1 cutting block. The
nature of the anterior cut, notching of the lateral or medial cortex and the need for lateral retinacular release were recorded.
The efficacy of CAS in setting optimal femoral component rotation is not clear. Setting a fixed rotation of three degrees from
PCA may lead to rotational malalignment in several patients. The aims of this study were to establish the relationship between
Whiteside’s axis and the PCA to address issues with patellar tracking. All collected data were tabulated and statistically analyzed
using SPSS13.0 software. The 2-tailed test was used to establish correlation.
Results:
The mean femoral component external rotation with respect the degree of varus deformity in extension/ flexion and
external rotation (r = 0.225, 0.477).
Discussion:
The external rotation with respect to the posterior condylar axis to align the femoral component to Whiteside line
varies with each knee (range: 0-14 degrees). The external rotation required in a varus knee increases with the degree of varus
deformity in extension as well as in flexion. Computer-assisted navigation helps in obtaining an optimal rotational alignment
of the distal femur when Whiteside line is taken as a reference.
Recent Publications:
1. Kumar R, Kiran EK, Malhotra R and Bhan S (2002) Surgical management of the severely displaced supracondylar
fracture of the humerus in children. Injury 33(6):517-522.
2. Bhan S, Malhotra R and Eachempati K K et al., (2004) MidtermComparative analysis of IB- II versus LCS at minimum
4.5 years follow up. Journal of Bone and Joint Surgery 86(11):2431-4.
3. Malhotra R, Bhan S and Eachempati KK (2005) Recurrent hemarthrosis following total knee arthroplasty due to
isolated pf3 availability defect. Journal of Bone and Joint Surgery 87-B: 1549-1552.
4. Bhan S, Malhotra R and Eachempati KK (2006) Prospective evaluation of total knee arthroplasty without patellar
resurfacing in severely degenerated knees with rheumatoid arthritis: Amidterm follow up study. Clinical Orthopaedics
& Related Research. 450:157-163.
5. Bhan S, Eachempati KK and Malhotra R (2008) Primary cement less total hip arthroplasty for bony ankylosis in
patients with ankylosing spondylitis. Journal of Arthroplasty 23(6):859-866.
E Krishna Kiran
Maxcure Hospitals, India