Rotational Alignment of the Femoral Component in Total Knee Arthroplasty

James A. D'Antonio, Sewickley, Pennsylvania

Seminars in Arthroplasty, Volume 7, Number 3 (July), 1996, pp 232-238

Abstract: Correct rotational alignment of the femoral component during total knee arthroplasty is necessary to create a balanced flexion and extension gap as well as a balanced patellofemoral articulation. Correct rotation can be achieved by using reliable anatomic landmarks. The three most reliable techniques to guage rotational alignment include the use of the anteroposterior axis, the transepicondylar axis, and the creation of the appropriate anterior footprint.

Dynamics of Knee Malalignment

Thomas P. Andriacchi, Ph.D., Chicago, Illinois

Orthopedic Clinics of North America, Volume 25, Number 3, July 1994, pp 395-403

Abstract: The dynamics of malalignment are based on the combination of the static limb alignment and the dynamics of loading at the knee during walking and other activities of daily living. Dynamic loading at the knee can be influenced by subconscious control of limb position such as foot placement, active muscle contraction, passive soft-tissue stability, as well as the speed of walking. The loads that are generated during these dynamic activities are substantially greater than the loads that can be generated during static postures. Therefore, limb alignment based on static radiographic measurements provides one component to the complete analysis of the factors influencing loading at the knee joint. Loading at the knee joint is an important consideration in the progression of degenerative processes at the knee as well as in the planning and selection of certain treatment modalities. Dynamic malalignment that occurs during activities such as gait should be considered in evaluating the progression of disease processes as well as the selection of appropriate treatment modalities.