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Year : 2021  |  Volume : 9  |  Issue : 2  |  Page : 68-72

The influence of referencing system on PCO and PCOR in primary total knee arthroplasty and its effect on postoperative range of motion and functional scores

Sunshine Hospitals, Hyderabad, Telangana, India

Correspondence Address:
Dr. Aditya P Apte
Sunshine Hospitals, Hyderabad, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JOASP.JOASP_39_21

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OBJECTIVE: The restoration of native posterior condylar offset (PCO) is considered to be an integral component of a successful total knee arthroplasty (TKA). Its effect on postoperative flexion is still not clear. The two referencing systems viz. anterior and posterior differ in their basic philosophy for selecting the appropriately sized femoral component. In this study, we aimed to evaluate their effect on the PCO, posterior condylar offset ratio (PCOR), notching, and anterior flange bone contact ratio. We also evaluated the influence of referencing system on postoperative flexion and functional scores at 2-year follow-up. MATERIALS AND METHODS: This was a retrospective single-center, single-surgeon study. Total 200 primary TKA (100––anterior referencing [AR]; 100––posterior referencing [PR]) were evaluated. The PCO and PCOR were measured pre- and postoperatively. In addition, if the femoral component was not seated properly, anterior flange–bone contact ratio and the incidence of notching were documented as well. RESULTS: Postoperatively, the mean PCO increased to 3.24 and 3.04 from 2.90 and 2.85 in the PR and AR groups, respectively. The comparative increase in PR group was significant (P < 0.001). Likewise, the PCOR increased postoperatively in both the groups and the comparative increase in PR was significant (P < 0.00). However, the comparative increase in flexion was not significant (P = 0.72)CONCLUSION: PR system provides better contact between anterior flange and anterior cortex of the femur. It also led to a significant increase in PCO and PCOR postoperatively. However, this does not significantly influence the ROM and Oxford knee scores at 2-year follow-up.

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