Abstract
Introduction
Tibial component malrotation is one of the commonest causes of pain and stiffness following total knee arthroplasties, however, the assessment of tibial component malrotation on imaging is not a clear-cut.
Aim
The objective of this study was to assess tibial component rotation in cases with pain following total knee replacement using MRI with metal artifact reduction technique.
Methods
In 35 consecutive patients presented to our clinic between January 2016 and April 2017 with persistent unexplained moderate to severe pain for at least 6 months following total knee arthroplasties after exclusion of infection, MRI evaluation of tibial component rotation using O-MAR technique-(Metal Artifact Reduction for Orthopedic implants) to improve visualization of soft tissue and bone by reducing artifacts caused by metal implants- was done according to the technique of Berger et al.
Results
25 cases showed internal rotation of tibial component, 5 cases showed neutral rotation, 5 cases showed external rotation with presence of abnormal intraarticular fibrous bands.
Conclusion
Two main conclusions are obtained from this study:
-
Firstly: Internal rotation of tibial component must be excluded in all cases of persistent pain following total knee replacement.
-
Secondly: Magnetic resonance imaging with the newly developed metal artifact reduction techniques is a very useful tool in evaluating cases of unexplained pain following total knee replacement.
