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Kinematic analysis of the flexion axis for correct femoral component placement

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy

Abstract

Purpose

This study evaluates a new method for intraoperative determination of femoral component rotation by a navigation system (flexion axis, FA) driven by joint stability over the range of motion.

Methods

Seventy-five patients were treated with a navigated total knee replacement. Intraoperatively, the posterior condylar axis (PCA), the Whiteside′s line (WL), and the surgical epicondylar axis (EA) were palpated, the flexion gap (FG) was determined, and the FA was calculated. The anatomical landmarks, lines, and angles were determined based on a postoperative computed tomography in all knees. The femoral rotation was intraoperatively determined by the surgeon based on the knowledge of the EA, the PCA, and the FG but not the FA.

Results

The deviation of the palpated EA was 3.5° [0°–13.8°], of the PCA externally rotated by 3° was 2.2° [0°–9.6°], of the WL was 3.8° [0.1°–10.0°], of the FG was 2.5° [0.2°–8.8°], and of the FA was 2.5° [0°–10.0°].

Conclusions

The FA is a new functionally acquired axis for the determination of optimal femoral component alignment. Whether the FA leads to clinically superior results must be clarified by subsequent studies.

Level of evidence

I.

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Acknowledgments

We want to thank Mr. Jan Stifter, who supported this study intellectual and with the soft- and hardware necessary to perform the determination of the flexion axis (Smith & Nephew). The study was financially supported by a grant of Smith and Nephew. Smith and Nephew was involved in the development of the mathematical algorithm and the implementation into the navigation system. The company did not influence in any other way than this the study methods, results, or interpretation of the data, so that there are no conflicts of interest in connection with this paper.

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Authors and Affiliations

  1. Department of Orthopaedic, Center for Musculoskeletal Surgery, Charité—University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany

    Georg Matziolis, Georgi Wassilew & Carsten Perka

  2. Department of Orthopaedic, Helios Clinic Bad Gandersheim, Bad Gandersheim, Germany

    Sascha Pfiel & Hinrich Boenicke

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  1. Georg Matziolis
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  2. Sascha Pfiel
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Corresponding author

Correspondence to Georg Matziolis.

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Matziolis, G., Pfiel, S., Wassilew, G. et al. Kinematic analysis of the flexion axis for correct femoral component placement. Knee Surg Sports Traumatol Arthrosc 19, 1504–1509 (2011). https://doi.org/10.1007/s00167-011-1554-5

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  • DOI: https://doi.org/10.1007/s00167-011-1554-5

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