Does sagittal alignment of the femoral component have an impact on radiological loosening and functional results in revision knee arthroplasty?

Abstract

Objectives: In this study, we aimed to investigate the effect of sagittal alignment of the femoral component on both radiological loosening and functional results in revision total knee arthroplasty (rTKA), as well as the anterior condylar offset (ACO) and posterior condylar offset (PCO).

Patients and methods: Between December 2005 and November 2020, a total of 47 patients (12 males, 35 females; mean age: of 67.1±8.4 years; range, 52 to 90 years) who underwent rTKA due to aseptic prosthesis failure were retrospectively analyzed. Demographic data including age, sex, body mass index (BMI), and clinical outcomes of the patients were recorded. Early postoperative sagittal alignment of the femoral component, ACO, and PCO were measured. Radiological loosening of patients was evaluated using the modified Knee Society Score, while the functional outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS).

Results: The mean follow-up was 55.4±28.0 (range, 24 to 142) months. While there was a moderate and inverse correlation between the sagittal alignment of the femoral component and ACO (p=0.002), there was no significant correlation between the sagittal alignment of the femoral component and PCO (p=0.980). There was a weak and inverse correlation between BMI and KOOS (p=0.024). There was no significant relationship between the sagittal alignment of the femoral component, ACO, PCO, age, and sex with radiological loosening (p=0.241) or KOOS (p=0.894).

Conclusion: In rTKA, sagittal alignment of the femoral component does not affect radiological loosening and functional results. The sagittal alignment of the femoral component exhibits a moderate and inverse correlation with ACO, while it has no significant correlation with PCO.

Citation: Çimen O, Mert M, Navat A, Köksal A, Öner A, Dırvar F, et al. Does sagittal alignment of the femoral component have an impact on radiological loosening and functional results in revision knee arthroplasty?. Jt Dis Relat Surg 2023;34(3):651-660. doi: 10.52312/jdrs.2023.1002.

The study protocol was approved by the Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital Medical Specialty Education Board (date: 26.11.2020, no: 65/447). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Study design, writing the article: O.Ç,; Radiological measurement and functional scoring: M.M.; Radiological measurement: A.N.; Clinical evaluations of patients: A.K.; Study desing and evaluating patients: A.O.; Study design and last control: F.D.; Last control: D.K.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.

We would like to thank Edvard Tony Karakaş for his assistance in the translation and editing of the foreign language content.

A written informed consent was obtained from each patient.

The data that support the findings of this study are available from the corresponding author upon reasonable request.