title: The Influence of Alignment on Midterm Outcome after Total Knee Arthroplasty in Patients With Marked Coronal Femoral Bowing.
abstract: Whether the mechanical axis should be restored to neutral remains controversial when the patient has marked coronal femoral bowing. Eighty-four total knee arthroplasties were retrospectively reviewed. In the neutral-aligned group A the immediate postoperative mechanical axis of 179 ± 1° held stable (P = 0.841). The postoperative mechanical axis decreased from 176 ± 1° to 173 ± 1° (P = 0.024) in the outlier group. Progressive varus in the outlier group at follow-up was probably due implant instability and ligament imbalance as well as excessive polyethylene wear. At a mean follow-up of 75.8 months, no statistically significant difference was detected between the two groups. Long-term follow up will be needed to determine if the maintenance in radiographic results translates to better clinical outcomes.
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; Chang Gung University, Taoyuan, Taiwan.
authors.forename: Tsan-Wen
authors.initials: TW
authors.lastname: Huang
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Shih-Jie
authors.initials: SJ
authors.lastname: Lin
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; Chang Gung University, Taoyuan, Taiwan.
authors.forename: Mel S
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; Chang Gung University, Taoyuan, Taiwan.
authors.forename: Robert Wen-Wei
authors.initials: RW
authors.lastname: Hsu
authors.affiliation: Po-Cheng Orthopaedic Institute, Kaohsiung, Taiwan.
authors.forename: Wun-Jer
authors.initials: WJ
authors.lastname: Shen
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005269:Femur / Q000002:abnormalities / Q000601:surgery*; D056305:Genu Varum / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D020959:Polyethylene / Q000737:chemistry; D011184:Postoperative Period; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013314:Stress, Mechanical; D016896:Treatment Outcome
chemical_list: D020959:Polyethylene
keywords: bowing of the femur; implant longevity; mechanical axis; polyethylene wear; total knee arthroplasty