Assessment of relative rotational alignment in total knee arthroplasty: usefulness of the modified Eckhoff method

Yamada, Kentaro; Imaizumi, Tsukasa

doi:10.1007/s007760050135

Cited by 13 publications

(3 citation statements)

References 11 publications

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“…A strength of this study is that is the first paper using three dimensional computed tomography to assess implant orientation and position for correlation with retrieval findings. Other research groups have identified TKA position using more traditional techniques, such as x-ray [7,8,16,[26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography Techniques Help Understand Wear Patterns in Retrieved Total Knee Arthroplasty

Cerquiglini

Henckel

Hothi

et al. 2018

The Journal of Arthroplasty

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Section: Discussionmentioning

confidence: 99%

Computed Tomography Techniques Help Understand Wear Patterns in Retrieved Total Knee Arthroplasty

Cerquiglini

Henckel

Hothi

et al. 2018

The Journal of Arthroplasty

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“…The inclusion of fluoroscopy to determine the relative rotation of the components, and using the AP lengths of the femoral and tibial components for magnification rather than the small pegs, was used in a modified method to improve accuracy. 61 Takai et al 62 described the kneeling view for assessment of the femoral component rotation, where this is the angle formed between the transepicondylar line and a line drawn tangential to the posterior condyles of the component. Limitations were observed in patients with anterior knee pain and instability due to problems kneeling, leading to a modification of the technique, taking the axial radiograph with the patient in a sitting position.…”

Section: Rotation Of the Componentmentioning

confidence: 99%

The radiological assessment of total and unicompartmental knee replacements

Sarmah

Patel

Hossain

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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Radiological assessment of total and unicompartmental knee replacement remains an essential part of routine care and follow-up. Appreciation of the various measurements that can be identified radiologically is important. It is likely that routine plain radiographs will continue to be used, although there has been a trend towards using newer technologies such as CT, especially in a failing knee, where it provides more detailed information, albeit with a higher radiation exposure. The purpose of this paper is to outline the radiological parameters used to evaluate knee replacements, describe how these are measured or classified, and review the current literature to determine their efficacy where possible.

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“…This single axis around which the tibia rotates in space is not captured in any of the traditional coronal, sagittal, or transverse planes and attempts to project it onto these planes gives rise to an artifact. Therefore the use of a surrogate axis passing through identifiable landmarks has been proposed as a solution [1,2,[4][5][6][7]30]. Churchill et al [6] suggested a line passing through the most medial and lateral portions of the epicondyles, the transepicondylar axis (TEA), best approximates the actual flexion-extension axis (FEA) of the knee.…”

Section: Introductionmentioning

confidence: 99%

Cylindrical Axis, Not Epicondyles, Approximates Perpendicular to Knee Axes

Hancock

Winston

Bach

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background The transepicondylar axis (TEA) is often used as a surrogate for the flexion-extension axis, ie, the axis around which the tibia moves in space, because of a belief that both axes lie perpendicular to the mechanical axis. However, studies suggest the cylindrical axis (CA), defined as a line equidistant from contact points on the medial and lateral condylar surfaces from 10 o to 120 o flexion, more closely approximates the axis around which the tibia moves in space.Questions/purposes We examined the TEA and CA angles relative to mechanical axes to determine whether one more consistently and closely approximates the surgical goal of orthogonality to the mechanical axis. Methods Three-dimensional (3-D) models were reconstructed from CT scans of five cadaver limbs. Three observers repeated three measurement sets to locate the TEA, CA, and femoral mechanical and tibial mechanical axes. Angles of the TEA and CA relative to the mechanical axes were calculated in two-dimensions (2-D) and as 3-D projections and compared for differences in magnitude and variance. Results Angles between CA and the mechanical axes were closer to 90°than the TEA in 2-D (92°versus 94°for the femur, 93°versus 94°for the tibia) and 3-D (88°versus 87°for the femur, 88°versus 86°for the tibia). Variance of the TEA was higher than the CA in 2-D. Conclusions The CA forms angles more orthogonal to the mechanical axes of the thigh and leg than the TEA. Clinical Relevance Although we found a consistently greater deviation of the TEA from the mechanical axis than the CA with small differences, future studies will need to determine whether these differences are biomechanically or clinically important.

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Assessment of relative rotational alignment in total knee arthroplasty: usefulness of the modified Eckhoff method

Cited by 13 publications

References 11 publications

Computed Tomography Techniques Help Understand Wear Patterns in Retrieved Total Knee Arthroplasty

Computed Tomography Techniques Help Understand Wear Patterns in Retrieved Total Knee Arthroplasty

The radiological assessment of total and unicompartmental knee replacements

Cylindrical Axis, Not Epicondyles, Approximates Perpendicular to Knee Axes

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