Evaluation of outcomes based on femoral component rotation in patients undergoing knee replacement surgery at Baqiyatallah University of medical science

Abstract

Author(s): Sadra Haji, Mehdi Abaszadeh, Mohamad Kazem Emami Mebodi, Mohamadhosein Mokhtari and Iman Ghazizadeh*

Introduction and Purpose: Knee arthroplasty is a common surgical procedure and knee joint replacement is a widely used intervention in the management of osteoarthritis. In elderly patients, the walking pattern may change due to arthritis and underlying diseases, which causes functional limitations. Various studies show that the correct rotation of the components in Total Knee Arthroplasty (TKA) by affecting the tibiofemoral and patellofemoral kinematics may affect the patient's performance after surgery and various studies have shown that the malrotation of the femoral component clinically by affecting the tibiofemoral and patellafemoral kinematics affects the patient's satisfaction after surgery, surgery is effective. This study aims to a study of the results of total knee joint replacement surgery based on rotation of the femur fragment was carried out at Baqiyatullah University of Medical Sciences.

Materials and Methods: This study was conducted as a retrospective cohort. With the census sampling method, all patients who underwent knee surgery in 1400 at Baqiyat Elah Azam Hospital were included in the study. The inclusion criteria included: patients with severe osteoarthritis with involvement of at least two compartments, who underwent UC TKA by Aescolap company. were placed and the exclusion criteria included: people with vascular disorders and underlying diseases (diabetes, neurological diseases, psychological diseases, collagen diseases, radiculopathy disability).

In the next stage, after obtaining permission and receiving the code of ethics from the university, the researcher was introduced to the medical records unit, then the information of the patients who underwent knee joint replacement surgery was extracted, and the patients were divided into two groups based on fixed femoral component rotation and also variable femoral component rotation and then the WOMAC questionnaire was completed by contacting the patients. Finally, all information was entered into SPSS version 22 and analyzed.

Results: In this study, 22 (26.2%) male patients and 62 (73.8%) female patients were studied. The average age of patients in the fixed group was 63.61 years ± 6.06 years and in the variable group was 65.54 years ± 4.26 years. In general, no statistically significant difference was found between the average age of patients (p=0.096) and the gender distribution of patients (p=0.620) between the two fixed and variable groups. The results of the WOMAC test in the initial follow-up of the patients showed that the pain score, the physical function score, and the WOMAC questionnaire score in general were significantly higher in patients with a fixed component than in the group with a variable component (p<0.005), also ,there was no significant difference in Joint stiffness.

Conclusion: Our study showed that malrotation of the femoral component has a clinical effect on the patient's satisfaction after surgery by affecting the tibiofemoral and patellofemoral kinematics, the increase in the prevalence of TKA highlights the increasing need for proper evaluation of the postoperative result. It increases the satisfaction and function of the patients from surgery. The correct selection of rotation of the femoral prosthesis in a variable manner (according to each person) based on the surgical transepicondylar line improves physical function and reduces pain after surgery compared to the selection of rotation of the femoral prosthesis in a fixed manner based on the posterior condylar line.

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