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- Talk
- 22/09/2022
- UK
Knee Replacements Done With Neutral Mechanical Alignment Technique Often Results In Overstuffing Of The Distal Lateral Femoral Condyle – An Analysis Using MRI Based 3D Modelling
Description
The presentation by Manikandar Srinivas Cheruvu, an Orthopedic Registrar from the Oswestry Rotation, discusses the findings of an anatomical study on total knee replacements, emphasizing the issues surrounding neutral mechanical alignment and its impact on postoperative pain. Cheruvu highlights that total knee replacements are commonplace in the UK, with ongoing debates regarding patient satisfaction and pain, particularly anterior knee pain that persists even a decade after the procedure.
The study employed MRI-based 3D modeling techniques to explore the overstuffing of the distal lateral femoral condyle, seeking to understand if this phenomenon contributes to residual knee pain. It was noted that common practice adopts a neutral mechanical alignment approach rather than an anatomical one, leading to concerns of resection mismatches especially in varus conditions.
Cheruvu presented data from a retrospective study of 292 patients, correlating medial condylar resections with cartilage mapping. The results revealed a mean overstuffing of 2 mm in varus knees and 4 mm in valgus knees. Laboratory simulations indicated that this overstuffing significantly increases joint reaction forces at the patella, potentially contributing to discomfort.
Finally, Cheruvu questions whether a rigid alignment philosophy is beneficial or if a more flexible approach to alignment could yield better outcomes, ultimately addressing whether these findings hold clinical relevance in the management of total knee replacements.