Computed tomography is not necessary to assess rotation of the femoral component in navigation-assisted total knee replacement

Hernández-Vaquero, Daniel; Noriega-Fernandez, Alfonso; Pérez-Coto, Iván; Garcia, Manuel A. Sandoval; Sierra-Pereira, Andres A.; Roncero-Gonzalez, Sergio; Fernández-Carreira, José Manuel

doi:10.1177/0300060516665258

Cited by 4 publications

(2 citation statements)

References 26 publications

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“…There was no statistically significant difference in the ROM between the two groups. These outcomes are shown in Table 2 [4, 5, 7, 10–12, 17, 23, 24, 29, 31–33, 35, 41, 43, 46, 48, 52, 56, 57].…”

Section: Resultsmentioning

confidence: 99%

Intra- and postoperative assessment of femoral component rotation in total knee arthroplasty: an EKA knee expert group clinical review

Skowronek¹,

Arnold

Stärke

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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PurposeMalrotation of the femoral component after primary total knee arthroplasty (TKA) is one of the most important problems leading to painful TKA requiring revision surgery. MethodsA comprehensive systematic review of the literature was performed to present current evidence on how to optimally place the femoral component in TKA. Several landmarks and techniques for intraoperative determination of femoral component placement and examination of their reliability were analyzed. Results2806 articles were identified and 21 met the inclusion criteria. As there is no unquestioned gold standard, numerous approaches are possible which come along with specific advantages and disadvantages. In addition, imaging modalities and measurements regarding postoperative femoral component rotation were also investigated. Femoral component rotation measurements on three‐dimensional (3D) reconstructed computerised tomography (CT) images displayed intraclass correlation coefficients (ICC) above 0.85, significantly better than those performed in radiographics or two‐dimensional (2D) CT images. Thus, 3D CT images to accurately evaluate the femoral prosthetic component rotation are recommended, especially in unsatisfied patients after TKA. ConclusionThe EKA Femoral Rotation Focus Group has not identified a single best reference method to determine femoral component rotation, but surgeons mostly prefer the measured resection technique using at least two landmarks for cross‐checking the rotation. Level of evidenceIII.

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Section: Resultsmentioning

confidence: 99%

Intra- and postoperative assessment of femoral component rotation in total knee arthroplasty: an EKA knee expert group clinical review

Skowronek¹,

Arnold

Stärke

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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show abstract

“…Many surgeons have determined the sTEA after distal femur resection [ 8 ]. However, in most navigation systems, the registration of the sTEA precedes the distal femur resection [ 9 , 10 ]. This sequential difference can influence the accuracy of intraoperative determination for sTEA when considering the proximal location of the anatomical references for sTEA and the arthritic environment [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Appropriate determination of the surgical transepicondylar axis can be achieved following distal femur resection in navigation-assisted total knee arthroplasty

Song

Lee

Kim

et al. 2021

Knee Surg & Relat Res

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Background Many surgeons have determined the surgical transepicondylar axis (sTEA) after distal femur resection in total knee arthroplasty (TKA). However, in most navigation systems, the registration of the sTEA precedes the distal femur resection. This sequential difference can influence the accuracy of intraoperative determination for sTEA when considering the proximal location of the anatomical references for sTEA and the arthritic environment. We compared the accuracy and precision in determinations of the sTEA between before and after distal femur resection during navigation-assisted TKA. Methods Ninety TKAs with Attune posterior-stabilized prostheses were performed under imageless navigation. The sTEA was registered before distal femur resection, then reassessed and adjusted after distal resection. The femoral component was implanted finally according to the sTEA determined after distal femur resection. Computed tomography (CT) was performed postoperatively to analyze the true sTEA (the line connecting the tip of the lateral femoral epicondyle to the lowest point of the medial femoral epicondylar sulcus on axial CT images) and femoral component rotation (FCR) axis. The FCR angle after distal femur resection (FCRA-aR) was defined as the angle between the FCR axis and true sTEA on CT images. The FCR angle before distal resection (FCRA-bR) could be presumed to be the value of FCRA-aR minus the difference between the intraoperatively determined sTEAs before and after distal resection as indicated by the navigation system. It was considered that the FCRA-bR or FCRA-aR represented the differences between the sTEA determined before or after distal femur resection and the true sTEA, respectively. Results The FCRA-bR was −1.3 ± 2.4° and FCRA-aR was 0.3 ± 1.7° (p < 0.001). The range of FCRA-bR was from −6.6° to 4.1° and that of FCRA-aR was from −2.7° to 3.3°. The proportion of appropriate FCRA (≤ ±3°) was significantly higher after distal femur resection than that before resection (91.1% versus 70%; p < 0.001). Conclusions The FCR was more appropriate when the sTEA was determined after distal femur resection than before resection in navigation-assisted TKA. The reassessment and adjusted registration of sTEA after distal femur resection could improve the rotational alignment of the femoral component in navigation-assisted TKA. Level of evidence IV.

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Comparison between navigated reported position and postoperative computed tomography to evaluate accuracy in a robotic navigation system in total knee arthroplasty

Figueroa

Wakelin²,

Twiggs³

et al. 2019

The Knee

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Computed tomography is not necessary to assess rotation of the femoral component in navigation-assisted total knee replacement

Cited by 4 publications

References 26 publications

Intra- and postoperative assessment of femoral component rotation in total knee arthroplasty: an EKA knee expert group clinical review

Intra- and postoperative assessment of femoral component rotation in total knee arthroplasty: an EKA knee expert group clinical review

Appropriate determination of the surgical transepicondylar axis can be achieved following distal femur resection in navigation-assisted total knee arthroplasty

Comparison between navigated reported position and postoperative computed tomography to evaluate accuracy in a robotic navigation system in total knee arthroplasty

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