- see: TKR menu
- Discussion:
- notching may occur with the anterior femoral cut;
- classification: 4 grades using the Tayside classification:
- grade I: violation of the outer table of the anterior femoral cortex;
- grade II: violation of the outer and the inner table of the anterior femoral cortex;
- grade III: violation up to 25% of the medullary canal (from the inner table to the center of the medullary canal);
- grade IV: violation up to 50% of the medullary canal (from the inner table to the center of the medullary canal) and unclassifiable.
- consequences of notching the femur:
- supracondylar periprosthetic femoral fracture
- Lesh ML, et al (2000): authors performed a biomechanical study to determine consequences of notching the femur;
- authors noted that femoral notching significantly lessens the load to failure following TKR and influences the subsequent fracture pattern;
- they recommended great care in the postop PT for these patients and recommended that these patients should not be subjected to knee manipulation;
- The consequences of anterior femoral notching in total knee arthroplasty. A biomechanical study.
- The Effect of Femoral Notching During Total Knee Arthroplasty on the Prevalence of Postoperative Femoral Fractures and on Clinical Outcome.
- Risk of periprosthetic fracture after anterior femoral notching.
- References: