Femoral component rotation and arthrofibrosis following mobile-bearing total knee arthroplasty

The purpose of this study was to evaluate the femoral component rotation in a small subset of patients who had developed arthrofibrosis after mobile-bearing total knee arthroplasty (TKA). Arthrofibrosis was defined as flexion less than 90° or a flexion contracture greater than 10° following TKA. From a consecutive cohort of 3,058 mobile-bearing TKAs, 49 (1.6%) patients were diagnosed as having arthrofibrosis, of which 38 (86%) could be recruited for clinical assessment. Femoral rotation of a control group of 38 asymptomatic TKA patients matched for age, gender, and body mass index was also evaluated. The surgical epicondylar axis was compared with the posterior condylar axis for the femoral prosthesis. Femoral components in the arthrofibrosis group were significantly internally rotated by a mean of 4.7° (SD 2.2°, range 10° internal to 1° external). In the control group, the femoral component had a mean 0.3° internal rotation (SD 2.3°, range 4° internal to 6° external). Following mobile-bearing TKA, there is a significant correlation between internal femoral component rotation and chronic arthrofibrosis.