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Excessive femoral torsion is not associated with patellofemoral pain or instability if TKA is functionally aligned and the patella denervated

PURPOSE: Recent data suggest that individual morphologic factors should be respected to restore preoperative patellofemoral alignment and thus reduce the likelihood of anterior knee pain. The goal of this study was to investigate the effect of excessive femoral torsion (FT) on clinical outcome of TK...

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Autores principales: Flury, Andreas, Hoch, Armando, Cirigliano, Gabriele, Hodel, Sandro, Kühne, Nathalie, Zimmermann, Stefan M., Vlachopoulos, Lazaros, Fucentese, Sandro F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10435632/
https://www.ncbi.nlm.nih.gov/pubmed/36114342
http://dx.doi.org/10.1007/s00167-022-07162-5
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author Flury, Andreas
Hoch, Armando
Cirigliano, Gabriele
Hodel, Sandro
Kühne, Nathalie
Zimmermann, Stefan M.
Vlachopoulos, Lazaros
Fucentese, Sandro F.
author_facet Flury, Andreas
Hoch, Armando
Cirigliano, Gabriele
Hodel, Sandro
Kühne, Nathalie
Zimmermann, Stefan M.
Vlachopoulos, Lazaros
Fucentese, Sandro F.
author_sort Flury, Andreas
collection PubMed
description PURPOSE: Recent data suggest that individual morphologic factors should be respected to restore preoperative patellofemoral alignment and thus reduce the likelihood of anterior knee pain. The goal of this study was to investigate the effect of excessive femoral torsion (FT) on clinical outcome of TKA. METHODS: Patients who underwent TKA and complete preoperative radiographic evaluation including a long-leg radiograph and CT scan were included. 51 patients showed increased FT of > 20° and were matched for age/sex to 51 controls (FT < 20°). Thirteen patients were lost to follow-up. Thirty-eight matched pairs were compared after a 2 year follow-up clinically (Kujala and patellofemoral score for TKA) and radiographically (FT, frontal leg axis, TT-TG, patellar thickness, patellar tilt, and lateral displacement of patella). Functional alignment of TKA was performed (hybrid-technique). All patellae were denervated but no patella was resurfaced. RESULTS: There was no significant difference between clinical scores two years after surgery between patients with normal and excessive FT (n.s.). Kujala score was 64.3 ± 16.7 versus 64.8 ± 14.4 (n.s.), and patellofemoral score for TKA was 74.3 ± 21 versus 78.5 ± 20.7 (n.s.) for increased FT group and control group, respectively. There was no correlation between preoperative FT and clinical scores. Other radiographic parameters were similar between both groups. No correlations between clinical outcomes and preoperative/postoperative frontal leg axis or total leg axis correction were found (n.s.). CONCLUSION: If the leg axis deformity is corrected to a roughly neutral alignment during cemented TKA, including patellar denervation, then excessive FT was not associated with patellofemoral pain or instability. LEVEL OF EVIDENCE. Prospective comparative study, level II.
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spelling pubmed-104356322023-08-19 Excessive femoral torsion is not associated with patellofemoral pain or instability if TKA is functionally aligned and the patella denervated Flury, Andreas Hoch, Armando Cirigliano, Gabriele Hodel, Sandro Kühne, Nathalie Zimmermann, Stefan M. Vlachopoulos, Lazaros Fucentese, Sandro F. Knee Surg Sports Traumatol Arthrosc Knee PURPOSE: Recent data suggest that individual morphologic factors should be respected to restore preoperative patellofemoral alignment and thus reduce the likelihood of anterior knee pain. The goal of this study was to investigate the effect of excessive femoral torsion (FT) on clinical outcome of TKA. METHODS: Patients who underwent TKA and complete preoperative radiographic evaluation including a long-leg radiograph and CT scan were included. 51 patients showed increased FT of > 20° and were matched for age/sex to 51 controls (FT < 20°). Thirteen patients were lost to follow-up. Thirty-eight matched pairs were compared after a 2 year follow-up clinically (Kujala and patellofemoral score for TKA) and radiographically (FT, frontal leg axis, TT-TG, patellar thickness, patellar tilt, and lateral displacement of patella). Functional alignment of TKA was performed (hybrid-technique). All patellae were denervated but no patella was resurfaced. RESULTS: There was no significant difference between clinical scores two years after surgery between patients with normal and excessive FT (n.s.). Kujala score was 64.3 ± 16.7 versus 64.8 ± 14.4 (n.s.), and patellofemoral score for TKA was 74.3 ± 21 versus 78.5 ± 20.7 (n.s.) for increased FT group and control group, respectively. There was no correlation between preoperative FT and clinical scores. Other radiographic parameters were similar between both groups. No correlations between clinical outcomes and preoperative/postoperative frontal leg axis or total leg axis correction were found (n.s.). CONCLUSION: If the leg axis deformity is corrected to a roughly neutral alignment during cemented TKA, including patellar denervation, then excessive FT was not associated with patellofemoral pain or instability. LEVEL OF EVIDENCE. Prospective comparative study, level II. Springer Berlin Heidelberg 2022-09-16 2023 /pmc/articles/PMC10435632/ /pubmed/36114342 http://dx.doi.org/10.1007/s00167-022-07162-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Knee
Flury, Andreas
Hoch, Armando
Cirigliano, Gabriele
Hodel, Sandro
Kühne, Nathalie
Zimmermann, Stefan M.
Vlachopoulos, Lazaros
Fucentese, Sandro F.
Excessive femoral torsion is not associated with patellofemoral pain or instability if TKA is functionally aligned and the patella denervated
title Excessive femoral torsion is not associated with patellofemoral pain or instability if TKA is functionally aligned and the patella denervated
title_full Excessive femoral torsion is not associated with patellofemoral pain or instability if TKA is functionally aligned and the patella denervated
title_fullStr Excessive femoral torsion is not associated with patellofemoral pain or instability if TKA is functionally aligned and the patella denervated
title_full_unstemmed Excessive femoral torsion is not associated with patellofemoral pain or instability if TKA is functionally aligned and the patella denervated
title_short Excessive femoral torsion is not associated with patellofemoral pain or instability if TKA is functionally aligned and the patella denervated
title_sort excessive femoral torsion is not associated with patellofemoral pain or instability if tka is functionally aligned and the patella denervated
topic Knee
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10435632/
https://www.ncbi.nlm.nih.gov/pubmed/36114342
http://dx.doi.org/10.1007/s00167-022-07162-5
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