Document Detail


Cam impingement of the posterior femoral condyle in unicompartmental knee arthroplasty.
MedLine Citation:
PMID:  23179453     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: There has been much emphasis on the importance of cam impingement, which is a cause of pain and knee hyperflexion restriction in unicompartmental knee arthroplasty (UKA). This study aimed to correlate cam impingement in the posterior femoral condyle with an α-angle showing the severity of the impingement. METHODS: The study groups consisted of 87 knees of 74 patients operated on with phase 3 medial Oxford UKA. Postoperatively, Group A (68 knees, 78.2 %) had no remnant of cam lesion; Group B (19 knees, 21.8 %) had cam lesion remnants. In Group C (18 knees, 20.7 %), which is a subgroup of Group A, cam lesions seen preoperatively were cleaned and not seen postoperatively. RESULTS: The mean increase in active flexion was 20.4° (±7.3°) in Group A, 9.7° (±6.1°) in Group B and 20.8° (±7.3°) in Group C. The difference between Group A and Group B and between Group B and Group C was statistically significant (p < 0.001, p < 0.001). The mean decrease of α-angle was 11.2° (±4.1°) in Group B, and 31.1° (±3.4°) in Group C. The difference was statistically significant (p < 0.001). Mean Oxford Knee Scores were 24 preoperatively, 41 postoperatively in Group A; 22 preoperatively, 38 postoperatively in Group B; and 24 preoperatively, 40 postoperatively in Group C. The differences were not significant. CONCLUSIONS: Posterior condylar cam lesion is an impingement which limits hyperflexion and may be an early clinical finding prior to bearing dislocation and wear. The α-angle is a marker showing the severity of this cam lesion. This problem can be overcome using intraoperative fluoroscan views during cam excison and replacing the femoral component in 105° knee flexion. LEVEL OF EVIDENCE: II.
Authors:
Murat Bozkurt; Ramazan Akmese; Nurdan Cay; Cetin Isik; Yenel Gurkan Bilgetekin; Merve Gulbiz Kartal; Osman Tecimel
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-23
Journal Detail:
Title:  Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA     Volume:  -     ISSN:  1433-7347     ISO Abbreviation:  Knee Surg Sports Traumatol Arthrosc     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9314730     Medline TA:  Knee Surg Sports Traumatol Arthrosc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Orthopaedics and Traumatology, Atatürk Training and Research Hospital, Faculty of Medicine, Yıldırım Beyazıt University, Bilkent, Ankara, Turkey, nmbozkurt@yahoo.com.
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