Interventions
peripheral nerve block, patellofemoral joint arthritis, TKA
OSTEOPHYTE, POSTERIOR
All participants underwent TKA and postoperative care following the hospital’s routine TKA program, which has been standardized through the use of clinical pathway protocols. Demographic data of patients including age, sex, body mass index, length of stay, pre-operative range of motion and ASA were collected. All TKA designs were performed using a cruciate retaining (CR) prosthesis from two manufacturers; ATTUNE (Depuy Synthes, Warsaw, Indiana) as a GR group and LEGION (Smith & Nephew, Memphis, TN) as a MR group. Patients receive a spinal anesthesia with peripheral nerve block prior to surgery. All cemented TKAs were performed with the same technique by the same experience surgeons; SL and KK, under tourniquet control. A standard midline skin incision was used, and the arthrotomy was done using a medial parapatellar approach. The distal femoral cut was made with a valgus angle of 6° to the femur anatomical axis using an intramedullary cutting guide, while the proximal tibial cut was made perpendicular to the mechanical axis using an extramedullary guide. Femoral sizing was measured using femoral sizing jig with the anterior referencing technique before anterior, posterior, and chamfer bony cuts were completely removed. Femoral rotational alignment was performed according to the epicondylar axis, usually 3° of external rotation from the posterior condylar line. Posterior femoral osteophyte was routinely removed before the tibial surface preparation. A range of 7°-10° of posterior tibial slope was aimed along with the native tibial slope. Patella was selective resurfaced only patella mal-tracking and/or severe patellofemoral joint arthritis was found. All patients were scheduled for the 6- and 12-months follow-up with the study coordinator at the same clinic for clinical review.