MRI evaluation of rotational alignment and synovitis in patients with pain after total knee replacement Academic Article uri icon


MeSH Major

  • Arthroplasty, Replacement, Knee
  • Knee Joint
  • Magnetic Resonance Imaging
  • Pain, Postoperative
  • Synovitis


  • Component malalignment can be associated with pain following total knee replacement (TKR). Using MRI, we reviewed 50 patients with painful TKRs and compared them with a group of 16 asymptomatic controls to determine the feasibility of using MRI in evaluating the rotational alignment of the components. Using the additional soft-tissue detail provided by this modality, we also evaluated the extent of synovitis within these two groups. Angular measurements were based on the femoral transepicondylar axis and tibial tubercle. Between two observers, there was very high interobserver agreement in the measurements of all values. Patients with painful TKRs demonstrated statistically significant relative internal rotation of the femoral component (p = 0.030). There was relative internal rotation of the tibial to femoral component and combined excessive internal rotation of the components in symptomatic knees, although these results were significant only with one of the observers (p = 0.031). There was a statistically significant association between the presence and severity of synovitis and painful TKR (p < 0.001). MRI is an effective modality in evaluating component rotational alignment.

publication date

  • September 2012



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1302/0301-620X.94B9.28489

PubMed ID

  • 22933492

Additional Document Info

start page

  • 1209

end page

  • 15


  • 94 B


  • 9