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Title of Journal: International Orthopaedics SICOT

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Abbravation: International Orthopaedics

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Springer-Verlag

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10.1016/j.arabjc.2015.02.015

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1432-5195

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Comparison of tibial rotation in fixed and mobile

Authors: James B Stiehl
Publish Date: 2008/07/11
Volume: 33, Issue: 3, Pages: 679-685
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Abstract

Tibial rotation is an important aspect of knee function and can be altered after total knee arthroplasty TKA These alterations include decreased internal rotation with knee flexion as compared to the normal state and paradoxical external rotation with flexion Mobile bearing total knee prostheses may allow greater unconstrained tibial rotation I compared tibial rotation after fixed bearing or mobile bearing total knee arthroplasty in 82 patients who underwent TKA with the tibia cut first technique to ascertain any differences Using intraoperative imageless computer navigation measurements included the determination of tibial rotation from extension to 90° flexion before and after prosthetic implantation with nonweightbearing range of motion I found that tibial rotation was significantly reduced after fixed bearing total knee replacement as compared to mobile bearing In addition the tibial position compared to the distal femur in extension was more external in fixed bearings compared to mobile bearings Placing the fixed tibial tray with increased internal rotation could explain this differenceLa rotation du tibia est un élément important sur le plan fonctionnel Elle peut être altérée après une prothèse totale du genou Ces altérations de la rotation portent sur une diminution de la rotation interne et paradoxalement une augmentation de la rotation externe en flexion Une prothèse totale du genou à plateau mobile permet une libération plus importante de la rotation tibiale Nous avons comparé cette rotation à partir de prothèses à la plateau fixe et à plateau mobile sur une série de 82 patients ayant bénéficie de cette arthroplastie avec une coupe première du tibia Nous avons utilisé pour cela un système de navigation per opératoire Nous avons trouvé à l’issue de cette étude que les rotations tibiales étaient significativement réduites après prothèse totale à plateau fixe versus prothèses à plateau mobile Par ailleurs la position du tibia en extension est en rotation externe par rapport au fémur distal Cette rotation est plus importante dans les prothèses à plateau fixe que dans les prothèses à plateau mobile Le positionnement du plateau tibial en rotation interne lors de l’intervention peut expliquer cette différence


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