title: Total knee replacement in patients with significant femoral bowing in the coronal plane: a comparison of conventional and computer-assisted surgery in an Asian population.
abstract: We conducted a retrospective study to investigate the effect of femoral bowing on the placement of components in total knee replacement (TKR), with regard to its effect on reestablishing the correct mechanical axis, as we hypothesised that computer-assisted total knee replacement (CAS-TKR) would produce more accurate alignment than conventional TKR. Between January 2006 and December 2009, 212 patients (306 knees) underwent TKR. The conventional TKR was compared with CAS-TKR for accuracy of placement of the components and post-operative alignment, as determined by five radiological measurements. There were significant differences in the reconstructed mechanical axes between the bowed and the non-bowed group after conventional TKR (176.2° (SD 3.4) vs 179.3° (SD 2.1), p < 0.001). For patients with significant femoral bowing, the reconstructed mechanical axes were significantly closer to normal in the CAS group than in the conventional group (179.2° (SD 1.9) vs 176.2° (SD 3.4), p < 0.001). Femoral bowing resulted in inaccuracy when a conventional technique was used. CAS-TKR provides an effective method of restoring the mechanical axis in the presence of significant femoral bowing.
authors.affiliation: Chang Gung Memorial Hospital, Chia Yi, Chang Gung University, No. 6, West Section, Chia Pu Road, Puzih, Chia Yi Hsien 613, Taiwan.
authors.forename: T-W
authors.initials: TW
authors.lastname: Huang
authors.forename: W-H
authors.initials: WH
authors.lastname: Hsu
authors.forename: K-T
authors.initials: KT
authors.lastname: Peng
authors.forename: R W-W
authors.initials: RW
authors.lastname: Hsu
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D044466:Asian People; D017760:Bone Malalignment / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome