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Risk factors and outcomes in asymmetrical femoral component size for posterior referencing bilateral total knee arthroplasty: a matched pair analysis
BACKGROUND: Theoretically, potential errors in femoral component (FC) sizing can affect postoperative functional outcomes after total knee arthroplasty (TKA), including range of motion (ROM), anterior knee pain, and flexion stability. Incidences of asymmetrical femoral components (AFC) in bilateral...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097347/ https://www.ncbi.nlm.nih.gov/pubmed/30115062 http://dx.doi.org/10.1186/s12891-018-2220-6 |
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author | Pinsornsak, Piya Chaiwuttisak, Adisai Boontanapibul, Krit |
author_facet | Pinsornsak, Piya Chaiwuttisak, Adisai Boontanapibul, Krit |
author_sort | Pinsornsak, Piya |
collection | PubMed |
description | BACKGROUND: Theoretically, potential errors in femoral component (FC) sizing can affect postoperative functional outcomes after total knee arthroplasty (TKA), including range of motion (ROM), anterior knee pain, and flexion stability. Incidences of asymmetrical femoral components (AFC) in bilateral TKA have been reported; however; there is a lack of data on exactly why AFC size selection may differ in patients who have had posterior referencing system bilateral TKA. Therefore, this study was conducted to determine risk factors of AFC size selection in patients specifically undergoing posterior referencing bilateral TKA and to compare clinical outcomes between those with AFC or symmetrical femoral component (SFC) sizes. METHODS: We conducted a retrospective matched-pair study comparing thirty-four patients who had undergone simultaneous and staged bilateral TKA using AFC size (Group I) and thirty-five patients with SFC size (Group II). Patients were matched according to gender, body mass index, prosthesis type, and operative technique. Preoperative radiographic morphology of both distal femurs including anteroposterior/mediolateral diameters, anterior-posterior femoral offset, and postoperative radiographic data of FC comprising flexion and valgus angle were recorded. The postoperative functional outcomes including ROM, anterior knee pain, knee society score, and functional score at 6 weeks, 3, 6, 12 and 24 months were compared. RESULTS: There were no differences in morphology between left and right distal femurs from preoperative radiographic data in both groups. The postoperative radiograph showed a significantly greater FC flexion angle difference in Group I vs. Group II (2.18° ± 1.29° and 1.36° ± 1.08° P = 0.007), while the other parameters were the same. The postoperative clinical outcomes displayed no distinction between groups. CONCLUSION: The factor primarily associated with AFC size selection in bilateral TKAs is the difference in FC flexion angle but not the morphological diversity between sides. The postoperative functional outcomes were not inferior in AFC patients in comparison with SFC patients. |
format | Online Article Text |
id | pubmed-6097347 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-60973472018-08-20 Risk factors and outcomes in asymmetrical femoral component size for posterior referencing bilateral total knee arthroplasty: a matched pair analysis Pinsornsak, Piya Chaiwuttisak, Adisai Boontanapibul, Krit BMC Musculoskelet Disord Research Article BACKGROUND: Theoretically, potential errors in femoral component (FC) sizing can affect postoperative functional outcomes after total knee arthroplasty (TKA), including range of motion (ROM), anterior knee pain, and flexion stability. Incidences of asymmetrical femoral components (AFC) in bilateral TKA have been reported; however; there is a lack of data on exactly why AFC size selection may differ in patients who have had posterior referencing system bilateral TKA. Therefore, this study was conducted to determine risk factors of AFC size selection in patients specifically undergoing posterior referencing bilateral TKA and to compare clinical outcomes between those with AFC or symmetrical femoral component (SFC) sizes. METHODS: We conducted a retrospective matched-pair study comparing thirty-four patients who had undergone simultaneous and staged bilateral TKA using AFC size (Group I) and thirty-five patients with SFC size (Group II). Patients were matched according to gender, body mass index, prosthesis type, and operative technique. Preoperative radiographic morphology of both distal femurs including anteroposterior/mediolateral diameters, anterior-posterior femoral offset, and postoperative radiographic data of FC comprising flexion and valgus angle were recorded. The postoperative functional outcomes including ROM, anterior knee pain, knee society score, and functional score at 6 weeks, 3, 6, 12 and 24 months were compared. RESULTS: There were no differences in morphology between left and right distal femurs from preoperative radiographic data in both groups. The postoperative radiograph showed a significantly greater FC flexion angle difference in Group I vs. Group II (2.18° ± 1.29° and 1.36° ± 1.08° P = 0.007), while the other parameters were the same. The postoperative clinical outcomes displayed no distinction between groups. CONCLUSION: The factor primarily associated with AFC size selection in bilateral TKAs is the difference in FC flexion angle but not the morphological diversity between sides. The postoperative functional outcomes were not inferior in AFC patients in comparison with SFC patients. BioMed Central 2018-08-16 /pmc/articles/PMC6097347/ /pubmed/30115062 http://dx.doi.org/10.1186/s12891-018-2220-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Pinsornsak, Piya Chaiwuttisak, Adisai Boontanapibul, Krit Risk factors and outcomes in asymmetrical femoral component size for posterior referencing bilateral total knee arthroplasty: a matched pair analysis |
title | Risk factors and outcomes in asymmetrical femoral component size for posterior referencing bilateral total knee arthroplasty: a matched pair analysis |
title_full | Risk factors and outcomes in asymmetrical femoral component size for posterior referencing bilateral total knee arthroplasty: a matched pair analysis |
title_fullStr | Risk factors and outcomes in asymmetrical femoral component size for posterior referencing bilateral total knee arthroplasty: a matched pair analysis |
title_full_unstemmed | Risk factors and outcomes in asymmetrical femoral component size for posterior referencing bilateral total knee arthroplasty: a matched pair analysis |
title_short | Risk factors and outcomes in asymmetrical femoral component size for posterior referencing bilateral total knee arthroplasty: a matched pair analysis |
title_sort | risk factors and outcomes in asymmetrical femoral component size for posterior referencing bilateral total knee arthroplasty: a matched pair analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097347/ https://www.ncbi.nlm.nih.gov/pubmed/30115062 http://dx.doi.org/10.1186/s12891-018-2220-6 |
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