Measuring long radiographs affects the positioning of femoral components in total knee arthroplasty: a randomized controlled trial

Stučinskas, Justinas; Robertsson, Otto; Lebedev, Aleksej; Wingstrand, Hans; Smailys, Alfredas; Tarasevičius, Šarūnas

doi:10.1007/s00402-016-2434-8

Cited by 7 publications

(2 citation statements)

References 34 publications

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“…With the lateral radiograph it is important to show posterior osteophytes that must be removed during surgery [14].…”

Section: Radiograph Examinationmentioning

confidence: 99%

Valgus Deformity Correction in Total Knee Replacement: An Overview

Bonanno

2024

Surgery of the Knee - From Arthroscopic to Open Approaches and Techniques

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The correction of deformities in valgus knee is a challenge to perform a total knee arthroplasty (TKA) for a surgeon. Approximately 10% of patients who sustain a TKA have a valgus deformity. The bone and soft tissue deformities complicate the restoration of proper alignment, positioning of components and achievement of joint stability. In the valgus knee are often present lateral femoral and tibial deficiencies, contracted lateral and elongated medial soft tissues and multiplanar deformities. Different classifications have been reported to guide surgical management and various surgical strategies have been described with variable clinical results. In relation to the severity of the deformity, different implant designs may be used. The important factors to obtain stability and longevity of TKA for good functional outcome are restoration of neutral mechanical axis and correct ligament balance.

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“…With the lateral radiograph it is important to show posterior osteophytes that must be removed during surgery [14].…”

Section: Radiograph Examinationmentioning

confidence: 99%

Valgus Deformity Correction in Total Knee Replacement: An Overview

Bonanno

2024

Surgery of the Knee - From Arthroscopic to Open Approaches and Techniques

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“…[ 11 ] The potential risk of this operative technology causing an error lies in deviation of the preoperative radiographic FVA measurement followed by intraoperative deviation of the direction of the femoral intramedullary rod from that of the femoral anatomic axis. [ 12 13 14 ] Another surgical technique that confirms the correspondence between measurements of resected condyle thickness obtained with calipers and measured on radiographs could verify the accuracy of distal femoral bone resection during TKA, which could improve the accuracy of conventional surgical techniques. [ 15 ]…”

Section: Introductionmentioning

confidence: 98%

Radiographic Measurement of Femoral Lateral Bowing and Distal Femoral Condyle Resection Thickness

Zhang

Zhao

et al. 2017

Chinese Medical Journal

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Background:Accurate evaluation of the plain radiography of lower limb is critical for preoperative planning of total knee arthroplasty (TKA). We aimed to investigate the effect of femoral lateral bowing and rotation on the radiographic measurements of distal femoral condyle resection thickness (DRT) and the distal femoral resection valgus angle (FVA).Methods:We analyzed 246 three-dimensional femoral models generated from computed tomography images of 123 patients, acquiring projected contours in seven positions – 20° and 10° internal rotation; 0° rotation; 10°, 20°, 30°, and 40° external rotation – for each model. Medial and lateral condyle DRTs, femoral shaft lateral bowing angle (FBA), and distal FVA were determined for each position. Linear mixed effect model was used to determine the effect of degree of femur rotation on repeated measurements of DRT or FVA.Results:FBA significantly affected the FVA and DRT (Pearson's R = 0.767 and −0.408, respectively; P < 0.000). Samples were divided into three groups according to the FBA measured in neutral position: FBA <0°: DRT 3.75 ± 1.30 mm, FVA 4.53° ± 1.27°; FBA >0° but <3°: DRT 3.39 ± 1.31 mm, FVA 5.92° ± 1.31°; FBA >3°: DRT 2.22 ± 1.31 mm, FVA 7.37° ± 1.31°. From simulated 20° internal rotation to 40° external rotation in each femoral model, the average variation ranges of radiographically measured DRT, FVA, and FBA were 0.50 ± 0.28 mm, 2.93° ± 0.96°, and 10.33° ± 1.90°, respectively, with no significant differences among the FBA groups. The degree of femoral rotation significantly affected the FVA (F = 62.148, P < 0.000), whereas there was no effect on condyle resection thickness (F = 0.4705, P = 0.494).Conclusions:Axial femoral rotation has less effect on radiographic measurements of differences in the DRT than on those of the distal FVA.

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