Principal Investigator: Nicholas J. Giori, MD, PhD Project Category: Arthritis - 2005 Objective: Total knee arthoplasty is an effective operation to reduce knee pain from arthritis. Total knee arthroplasty can fail if the knee replacement components are not placed properly on the bone. The alignment of the implant components is thought to be critical to the longevity and success of the knee replacement. One aspect of component alignment is rotation of the femoral component. Femoral component rotation is difficult to image with conventional radiology, so it is unknown what the variability of femoral component placement is. It is also unknown which of several alignment techniques gives the most reliable rotational placement of the femoral component. The purpose of this study is to investigate the variability of femoral component placement with various alignment techniques. Work Accomplished: We asked eleven experienced orthopedic surgeons to identify various femoral axes on ten cadaver femora. The axes identified reflected the techniques that are commonly used to orient the femoral component of knee replacements. We found that there was considerable variability in the placement of these axes among the eleven surgeons, and that none of the alignment techniques was statistically superior to the others. Expected Outcome: Based on the results of this study, we conclude that no currently used alignment technique is better than any other in guiding the surgeon to place the femoral component in proper rotational position. New techniques are needed. Publications: Siston RA, Patel JJ, Goodman SB, Delp SL, Giori NJ: High Variability of Femoral Alignment in Total Knee Arthroplasty. Trans Orthop Res Soc. 51:309, 2005. Siston RA, Giori NJ, Goodman SB, and Delp SL: In-vivo Passive Kinematics of Osteoarthritic Knees. XXth Congress of the International Society of Biomechanics, Cleveland, July 31- August 5, 2005. Siston RA, Goodman SB, Patel JJ, Delp SL, Giori NJ: The high variability of tibial rotational alignment. Knee Society 22nd Annual Interim Meeting, New York, NY, September 8-10, 2005. Siston RA, Daub AC, Giori NJ, Goodman SB, Delp SL: Evaluation of methods for determining the center of the ankle for computer-assisted total knee replacement. Clin Orthop 2005 439:129-135. Siston RA, Patel JJ, Goodman SB, Delp SL, Giori NJ: High variability of femoral rotational alignment in total knee arthroplasty. Journal of Bone and Joint Surgery 2005 87-A:2276-2280. Funding Source: No outside funding
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