Original ArticlesThe effect of surgeon experience on component positioning in 673 press fit condylar posterior cruciate-sacrificing total knee arthroplasties*,**
Section snippets
Materials and methods
Data are collected prospectively on all patients undergoing TKA at Princess Alexandra Hospital (PAH) for an ongoing research project. As part of this project, the component alignment of 673 posterior cruciate-sacrificing TKAs performed between January 1994 and December 1999 was measured. Radiographs were taken in a standard manner. The weight-bearing anteroposterior view was acquired using an 18 × 43 cm film and the knee in full extension, whereas the supine lateral view was taken using an 18 ×
Results
Radiographs of 673 implants were measured from 516 patients, of whom 157 had undergone simultaneous or staged bilateral TKAs. Surgery was performed by a consultant in 203 knees and by a trainee in 409 knees; the grade of surgeon was unknown in the remaining 61 knees, and these were excluded from the comparative analysis. Component alignment data are summarized in Table 1 and Fig. 3.Empty Cell Mean SD Mode Median Range Coronal
Discussion
Component position plays a fundamental role in the function of a TKA by determining the alignment of the knee and patellofemoral tracking. It has been shown previously that malpositioned TKAs have higher rates of failure 1, 2, 7 and are associated with radiolucent lines around the patellar component [8]. This study has shown that the combination of intramedullary femoral and extramedullary tibial cutting guides produced satisfactory component positioning in most knees. It is a concern, however,
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Funds were received in support of the research described in this article from Johnson & Johnson.
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Reprint requests: M. J. K. Bankes, 18 Howard Walk, London N2 OHB, U.K. E-mail: [email protected]