Subject(s)
Arthroplasty, Replacement, Hip/methods , Femur/surgery , Muscle, Skeletal/surgery , Adult , Bone Cements , Humans , ReoperationABSTRACT
Morphology of the distal femur is characterized in patients with osteoarthritis to identify an etiology for the high incidence of patellar till, subluxation, and failure noted in total knee arthroplasty. This study demonstrates that the sulcus of the trochlear groove is not located in the midline as traditionally represented, but is lateral to the midline in both osteoarthritic and normal knees. The significance of this is that the patella will presumably track lateral to the midline unless surgically realigned, contributing to the prevalence of patellar tracking problems associated with symmetric femoral components with centralized sulci used in contemporary total knee arthroplasty.
Subject(s)
Femur/surgery , Knee Joint/surgery , Knee Prosthesis , Osteoarthritis/surgery , Biomechanical Phenomena , Female , Femur/diagnostic imaging , Humans , Knee Joint/diagnostic imaging , Male , Osteoarthritis/diagnostic imaging , Patella/diagnostic imaging , Patella/surgery , Postoperative Complications/diagnostic imaging , Postoperative Complications/prevention & control , Prosthesis Failure , Reference Values , Tomography, X-Ray ComputedABSTRACT
By computed tomography scan, morphology of the femur in 20 adult patients with anterior knee pain was compared with that of ten volunteers without knee pain to identify femoral characteristics associated with the painful patella. Anteversion, measured as the difference between the axis of the head-neck and the axis of the posterior condyles, was significantly greater in symptomatic adults (p < 0.01). Configuration of the distal femur and position of the patella relative to the femur were similar in each group. Adult anterior knee pain was, therefore, associated with increased anteversion without compensatory change in trochlear morphology or patellar orientation to the femur.
