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External rotation of the tibial component
2%
96/4361
External rotation of the femoral component
5%
220/4361
Internal rotation of the femoral component
90%
3928/4361
Lateralization of the femoral component
1%
48/4361
Medialization of the patellar component
58/4361
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Internal rotation of the femoral component can lead to post-operative lateral patellar instability. The bony deficiency of a valgus arthritic knee is at the lateral femoral condyle. A total knee system that employs posterior condylar referencing can cause internal rotation of the femoral component if the lateral femoral condyle is deficient. Briard and Hungerford state that malalignment of any component can lead to patellar instability. Internal rotation of the femoral component increases the Q-angle, which increases the lateral pull of the knee extensors. External rotation of the femoral and tibial components both decrease the Q-angle. Lateralization of the femoral component and medialization of the patellar component also help stabilize the patella by decreasing the Q-angle. Lee et al showed good patellofemoral stability in a series of patients where attention was paid to avoidance of femoral and tibial component malrotation and prevention of overstuffing of the patellofemoral joint.
3.9
(19)
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