Femoral Trochlear Groove Recreation Following TKA Correlates with Improved Patient Reported Outcome

4 pages•Published: October 26, 2019

Joshua Twiggs, Edgar Wakelin, Stephen McMahon and Brad Miles

Abstract

Femoral component recreation of the trochlear groove is a major factor in determining post-operative patello-femoral tracking. Significant variation arises in recreation of the trochlear groove when a standardised implant design is applied to variable patient anatomy and alignment. However, the impact of variation on patient outcome is not well understood. This study sought to understand whether the accuracy of recreation of the trochlear groove drives patient outcome following total knee arthroplasty (TKA). 430 TKA patients were analysed; patients had pre- and post-operative CT scans and postoperative Knee Injury & Osteoarthritis Outcome (KOOS) scores at 6 months post- surgery. Based on the pre- and post-operative CT scans, femoral trochlear groove positioning and the post-surgery “build-up” of the medial and lateral apex either side of the groove were modeled and measured. Correlations between changes to this native morphology and KOOS scores were statistically tested. Patients who had increased implant build-up on the trochlear lateral apex had a worse outcome (correlation with KOOS Pain score: r = -0.2, p = 0.03), and this was found to be driven by impairment when straightening and pain when bending. The results suggest that reducing the proximal lateral apex of the trochlear groove post-implantation leads to improved patient outcomes when straightening the knee, with implications for both implant design and target component placement.

Keyphrases: arthroplasty, ct, knee, outcome, trochlear groove

In: Patrick Meere and Ferdinando Rodriguez Y Baena (editors). CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 3, pages 376-379.

Links:	https://easychair.org/publications/paper/zpbD
	https://doi.org/10.29007/8hbf

BibTeX entry

@inproceedings{CAOS2019:Femoral_Trochlear_Groove_Recreation,
  author    = {Joshua Twiggs and Edgar Wakelin and Stephen McMahon and Brad Miles},
  title     = {Femoral Trochlear Groove Recreation Following TKA Correlates with Improved Patient Reported Outcome},
  booktitle = {CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Patrick Meere and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {3},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/zpbD},
  doi       = {10.29007/8hbf},
  pages     = {376-379},
  year      = {2019}}

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