Rotational Alignment of the Femoral Component Using Trochlear Navigation During Total Knee Arthroplasty: A Dual-Center Study of 145 Cases

Rotational alignment of the femoral component during TKA is critical. Here we propose a technique using navigation of the femoral trochlea to determine the rotation of the femoral component. The rotation is considered “ideal” when the component position leads to the arthroplasty trochlea being perfectly superimposed over the native trochlea. Thus the arthroplasty trochlea will be aligned on the trochlear groove axis, which itself is perpendicular to the transepicondylar axis. This was a prospective, non-randomized, dual-center study involving 145 knees. In all knees, the rotation of the femoral component was determined intraoperatively by trochlear navigation. The alpha angle obtained with this method was compared to the one calculated on a preoperative or postoperative CT scan. There was excellent agreement between the results obtained with the CT scan method and the ones obtained with trochlear navigation.