Accuracy of intramedullary alignment in total knee replacement

Elloy, M.A.; Manning, M; Johnson, Robert G.

doi:10.1016/0141-5425(92)90080-5

Cited by 32 publications

(19 citation statements)

References 6 publications

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“…This seems to be in accordance with the amount of axis deformations typically found in patients prior to TKA. The degree of flexion and rotation over the knee joint both affect the coronal alignment on whole-leg standing films [16,17]. However, Wright et al concluded that rotation of the lower limb <10°did not have a significant effect on measurement of tibiofemoral alignment [18].…”

Section: Discussionmentioning

confidence: 99%

Varus Gonarthrosis Predisposes to Varus Malalignment in TKA

Heyse

Decking

Davis

et al. 2009

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Postoperative alignment is a predictor for longterm survival of total knee arthroplasty (TKA). The purpose of this study was to evaluate whether or not preoperative deformities predispose to intraoperative malposition of TKA components. A retrospective radiographic analysis of 53 primary TKA cases was performed. Preoperative AP hip to ankle and lateral knee radiographs were compared with postoperative views to evaluate component positioning. The following angles were measured: the hip-knee-ankle (HKA) angle expressing the mechanical axis of the leg, the mechanical lateral distal femur angle (mLDFA), the medial proximal tibia angle (MPTA), the posterior distal femur angle (PDFA), and the posterior proximal tibia angle (PPTA). Postoperative measurement of the HKA revealed 34.0% of the cases had a deviation of >±3°from neutral alignment. Sixteen knees (30.2%) were in varus and, with one exception, all presented with severe varus gonarthrosis prior to surgery with a mean tibiofemoral angle of 12.4°c ompared with 1.0°of valgus in the optimally aligned group. Patients (93.3%) with preoperative valgus malalignment showed optimal postoperative HKA. Odds ratios for malalignment of TKA for varus knees in comparison with valgus knees were 7

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Section: Discussionmentioning

confidence: 99%

Varus Gonarthrosis Predisposes to Varus Malalignment in TKA

Heyse

Decking

Davis

et al. 2009

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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“…These include the positioning of the limb, morphological variations in the femur and tibia, the quality of radiographs and the use of long or short films. 7,9,10,12,[14][15][16][17][18] Lonner et al 7 concluded that limb rotation and knee flexion of 10°, either alone or in combination, significantly affected radiological measurements of anatomical alignment. Wright et al, 16 however, showed that the effect on axial alignment was minimal within 10° of rotation and that radiological measurement was reliable.…”

Section: Discussionmentioning

confidence: 99%

Computerised measurement of tibiofemoral alignment

Prakash

Wigderowitz

McGurty

et al. 2001

The Journal of Bone and Joint Surgery. British volume

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T ibiofemoral alignment has a direct correlation with the survival of total knee arthroplasty. Traditionally, it has been measured using a goniometer on radiographs. We describe new software which measures this alignment on scanned radiographs by automatically detecting bones in the image.Two surgeons used conventional methods and two clerical officers used the computerised routine to assess 58 radiographs of the knee on two occasions. There were no significant differences between any of the paired comparisons. The largest mean difference detected was 1.19°. Across all comparisons, the mean correlation was 0.755. A standardised routine for measuring tibiofemoral alignment was the greatest factor in reducing error in our study.These results show that non-medical staff can reliably use the software to measure tibiofemoral alignment. It has the potential to measure all the parameters recommended by the Knee Society.

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“…Elloy [3] studied the accuracy of a system using intramedullary alignment: The mean error was 0.67°of valgus deviation from the mechanical axis; the maximum error was 6.68°v algus and 4.62°varus. Ritter [15] assessed the anatomic alignment: Kaplan-Meier survival curves showed significantly worse results in the varus group.…”

Section: Discussionmentioning

confidence: 99%