A Morphometric Study of the Distal Femoral Resected Surface In Osteoarthritis Knees of the Patients in Southwest China and a Comparison with Femoral Components in Six Total Knee Arthroplasty Systems

Ke, Song; Ran, Tianfei; Ma, Tianying; Qin, Yinyin; Zhang, Bokai; Wang, Min

doi:10.1111/os.13647

Cited by 3 publications

(3 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Computer-assisted surgery technology can be divided into vision-based optical navigation and gyroscope-based spatial navigation. 3 The MEMS-FEAO system is one type of the gyroscope-based CAS, which does not require preoperative collection of 3D images. It only requires program calculation of placement sensors to obtain a real-time spatial position of the femoral head center.…”

Section: Discussionmentioning

confidence: 99%

“…Computer‐assisted surgery technology can be divided into vision‐based optical navigation and gyroscope‐based spatial navigation 3 . The MEMS‐FEAO system is one type of the gyroscope‐based CAS, which does not require preoperative collection of 3D images.…”

Section: Discussionmentioning

confidence: 99%

“…We fully considered the characteristics of the shape of the Chinese femoral condyle in the actual operation process, 3 and personalized osteotomy was carried out based on the principle of no notching and excessive flexion angle of the prosthesis. The extramedullary alignment technology can avoid the impact of the anterior femoral arch, so we adopted the angle between the posterior tangent of the anterior femoral condyle of the femoral prosthesis and the mechanical axis of the femur as the measurement standard for FPFA.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Micro Electromechanical System Navigation Assists Femoral Extramedullary Alignment Osteotomy in Total Knee Arthroplasty: A Single‐Blind Randomizing Study

Zhang

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectiveA micro‐electromechanical system (MEMS) was developed based on spatial alignment and navigation technology to assist femoral extramedullary alignment osteotomy (FEAO) in total knee arthroplasty (TKA). The system can locate and adjust the femoral distal condylar osteotomy (FDCO) to obtain a better femoral prosthesis placement. It is a portable navigation device and provides an innovative approach for FDCO.MethodsSixty patients who suffered from severe knee osteoarthritis who underwent unilateral TKA from May 14, 2021 to May 30, 2022 were randomly divided into a MEMS‐FEAO group and a conventional femoral intramedullary alignment osteotomy (FIAO) group, with 30 cases in each group for a controlled retrospective study. The hip‐knee‐ankle angle (HKAA) of the lower limb was measured before and after surgery, the femoral valgus angle (FVA) was measured preoperatively, and the femoral prosthesis valgus angle (FPVA) and the femoral prosthesis flexion angle (FPFA) were measured postoperatively following computed tomography imaging protocols. Measurement data is statistically described as mean ± standard deviation c. The count data is described by frequency (constituent ratio) using the rank sum test.ResultA total of 6.7% (2/30) of FEAO compared to 20.0% (6/30) of FIAO cases were postoperative deviations where the HKAA exceeded ±3° of neutral alignment (p < 0.05). The postoperative HKAA was 178.74° ± 1.56° versus 176.64° ± 3.39° (p < 0.05), the HKAA deviation was 1.25° ± 1.56° versus 3.36° ± 3.40° (p < 0.05), and the FPFA was 4.85° ± 2.46° versus 6.60° ± 1.86°(p < 0.05). Therefore, the differences were all statistically significant between the two groups. However, the FPVA was −0.59° ± 2.73° versus −0.80° ± 2.85° (p > 0.05), and there was no statistical significance between the two groups.ConclusionThe MEMS‐FEAO system can improve the accurate alignment and can be utilized as a locator to obtain the best femoral prosthesis placement in TKA and significantly reduce the rate of poor force line of the lower limb.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Micro Electromechanical System Navigation Assists Femoral Extramedullary Alignment Osteotomy in Total Knee Arthroplasty: A Single‐Blind Randomizing Study

Zhang

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

Morphological Measurement and Clinical Significance of Abnormal Development of Distal Femur with Hemophilia Knee Arthritis: A Consideration on the Renewal of Total Knee Prosthesis

Feng,

Ye,

Fang

et al. 2024

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectiveThe knee joint of hemophiliacs may face the result of local morphological changes due to long‐term irritation of synovitis. This study aims to elucidate the morphological characteristics of distal femur in hemophilic arthritis (HA) and compare the compatibility of three types of prostheses with the anteroposterior (AP) and mediolateral (ML) dimensions of the femoral osteotomy surface.MethodsThis study retrospectively and randomly selected 50 patients with HA registered for treatment at our hospital from June 2016 to August 2022 as the study subjects, with an equal number of male osteoarthritis (OA) patients and healthy male individuals set as the control group. This study used medical digitalization software to simulate osteotomies on the distal femur during total knee arthroplasties (TKA) for 50 patients with HA, OA patients, and the healthy population, respectively, and measure the morphological parameters to compare with three commonly used femoral components of TKA in clinical practice. The differences between the femur resection of anteroposterior and mediolateral (FRAP, FRML) osteotomy surface and the prosthesis's BOX‐AP/ML were compared in three prostheses. One‐way ANOVA and multiple Kruskal–Wallis H test were used for the normal or non‐normal distribution data, and pairwise comparisons between groups were conducted using the Bonferroni method, and the linear correlation analysis was utilized to assess the relationship between section femoral morphological data and prosthesis parameters.ResultIn HA patients, the morphological characteristics of the distal femur were shown as shorter than femur AP (FAP), medial and lateral condyle anterior–posterior dimension (FMCAP, FLCAP), notch width (NW), posterolateral condyle height (PLCH), posteromedial condyle width (PMCW), and posterior condylar axis length (PCAL) dimension. They had comparatively smaller femur section aspect ratios (p < 0.005). They showed longer posterolateral condyle width (PLCW), anterior condyle mediolateral dimension (FRACML), anterolateral condyle height (ALCH), and femur resection anterior condylar mediolateral (FRACML) dimension (p < 0.005). They showed larger distal femur aspect ratio and resection aspect ratio (FAR, FRAR, p < 0.005). All selected prostheses showed ML undercoverage under similar AP dimensions, and ML undersizing of Attune systems was more obvious in three femoral prostheses.ConclusionThe distal femur morphological change of HA patient is shown as smaller AP dimension, narrow posterior condyle spacing, lower and shallower trochlear, thinner anterior condyle, wider and lower intercondylar notch and higher posterior‐lateral condyle. The selected prostheses showed ML undercoverage under similar AP dimensions. This typical morphological tendency of the distal femur seems to warrant consideration in the process of knee joint prosthesis upgrading.

show abstract

“Boot Sign” of Anterior Femoral Condylar Resectional Shape during Total Knee Arthroplasty Is More Frequent in Asian Patients

Kim,

Park,

Baek

et al. 2023

JPM

View full text Add to dashboard Cite

Purpose: There is lack of intraoperative consensus on the distal femur anterior resected surface shape that allows reliable rotational alignment assessment during total knee arthroplasty (TKA). We aimed to evaluate the ratio and prevalence of anterior femoral resection surface intraoperatively. Materials and Methods: The study included 234 osteoarthritis patients with varus knees and not valgus knees or deformities. After conventional medial parapatellar approach, measured resection technique based on the mechanical axis of the femur and preoperative TEA-PCA angle on CT with anterior reference was used among all the patients. The anteroposterior (AP) lengths after distal femoral resection were measured as the femoral lateral AP (FLAP) and femoral medial AP (FMAP) lengths. Based on the medial (MD) and lateral condyle (LD) vertical distance ratios of the femur anterior resected surface, the groups were classified into “boot sign”, “grand-piano”, and “butterfly sign” groups. For comparison of the mean values, the data were assessed for normality with the Shapiro–Wilk test. One-way ANOVA with post hoc analysis using Tukey’s honestly significant difference (HSD) test was used to compare the mean values among the groups. The correlations between the MD/LD and variables were analyzed using the Pearson correlation coefficient. Linear regression analyses were used to find the associated factors to the anterior femoral resection surface shape. Results: Mean intraoperative femoral rotation and distal femoral cutting angles were 4.9° ± 1.2 and valgus 5.0° ± 0.7, respectively. Mean FLAP was 52.9 ± 4.2 mm. Mean MD/LD (0.61 ± 0.13) was lower than that of typical “grand-piano sign”. The morphological shape incidence of the “boot sign” was 62.4%. In the “boot sign” group, the FLAP was found to be smaller than that in the other groups (52.4 ± 4.2 vs. 53.7 ± 4.2 vs. 54.9 ± 2.7; p = 0.02), while the intraoperative femoral rotation angle was found to be larger than in the other groups (5.0 ± 1.2 vs. 4.6 ± 1.1 vs. 4.7 ± 1.2; p = 0.039). The MD/LD-associated factors were FLAP, intraoperative femoral rotation, and distal femoral cutting angles (R2 = 0.268). Conclusion: The femur anterior resection surface shape in TKA was found in the “boot sign” rather than the “grand-piano sign” in Korean ethnics owing to an asymmetric morphology of femoral condyles. Ethnic differences, including distal femoral morphology, should be considered for assessment of the femoral rotation angle using the femur anterior resection surface shape.

show abstract

A Morphometric Study of the Distal Femoral Resected Surface In Osteoarthritis Knees of the Patients in Southwest China and a Comparison with Femoral Components in Six Total Knee Arthroplasty Systems

Cited by 3 publications

References 39 publications

Micro Electromechanical System Navigation Assists Femoral Extramedullary Alignment Osteotomy in Total Knee Arthroplasty: A Single‐Blind Randomizing Study

Micro Electromechanical System Navigation Assists Femoral Extramedullary Alignment Osteotomy in Total Knee Arthroplasty: A Single‐Blind Randomizing Study

Morphological Measurement and Clinical Significance of Abnormal Development of Distal Femur with Hemophilia Knee Arthritis: A Consideration on the Renewal of Total Knee Prosthesis

“Boot Sign” of Anterior Femoral Condylar Resectional Shape during Total Knee Arthroplasty Is More Frequent in Asian Patients

Contact Info

Product

Resources

About