A new measurement technique for the tibiofemoral contact point in normal knees and knees with TKR |
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Authors: | R J de Jong P J C Heesterbeek A B Wymenga |
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Institution: | (1) Department of Orthopaedics, Sint Maartenskliniek, Post box 9011, 6500 GM Nijmegen, The Netherlands;(2) Department of Research, Development & Education, Sint Maartenskliniek, Post box 9011, 6500 GM Nijmegen, The Netherlands; |
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Abstract: | Flexion gap instability after cruciate retaining TKR allows paradoxical anterior movement of the femur during flexion. The
tibiofemoral contact point (CP) moves anteriorly and produces a decrease in the lever arm of the extensor apparatus. This
can provoke patellofemoral, tibiofemoral-joint pain and instability for the patient. In order to quantify the amount of paradoxical
motion on a 90° flexion radiograph of the knee, the average normal CP of the natural knee should be known. There are no known
CP measurement methods suited for natural knees and knees with TKR that can be applied in daily practice, and only estimations
for the CP position have been made. Therefore, a CP measurement technique on lateral radiographs that can be applied to natural
knees and knees with a TKR has been developed. The reproducibility of this method was assessed. It was then used to determine
the normal range of the CP in natural knees. The medial contact point in the natural knee in 90° of flexion was determined
to be at 68% (±6.6%) of the AP diameter of the tibia measured below the tibia-plateau simulating a bone resection with TKR.
This reproducible CP measurement method can be used clinically to evaluate the CP after knee prosthesis and also in patients
with suspected ligament lesions. |
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