Prevalence and Predictors of Post-Operative Coronal Alignment Outliers and Their Association With the Functional Outcomes in Navigated Total Knee Arthroplasty

Chowdhry, Madhav; Bamne, Ankur B.; Na, Young Gon; Kang, Yeon June; Kim, Tae Kyun

doi:10.1016/j.arth.2014.07.015

Cited by 15 publications

(15 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Matsuda et al18) found that postoperative varus alignment resulted in lower patient satisfaction. Chowdhry et al19) found only a weak correlation between coronal limb alignment and functional outcome. Huang et al20) found that the patients had different satisfaction levels with the first and second knees after SBTKA, which was considered related to the order of TKA not to preoperative symptomatic severity of disease.…”

Section: Discussionmentioning

confidence: 98%

Component Alignment in Simultaneous Bilateral versus Unilateral Total Knee Arthroplasty

Qadir¹,

Shah²,

Waqas³

et al. 2019

Knee Surg Relat Res

View full text Add to dashboard Cite

PurposeThe purpose of this study was to investigate differences in component alignment between first and second knees in simultaneous bilateral total knee arthroplasty (SBTKA) and unilateral TKA (UTKA).Materials and Methods274 SBTKAs and 198 UTKAs were included in study. Patients were divided into three groups as SBTKA on the right knee (group A), SBTKA on the left knee (group B) and UTKA (group C). Femoral and tibial component alignment was checked in both coronal plane (alpha [α] and beta [β] angles) and sagittal plane (gamma [γ] and delta [δ] angles) radiographs.ResultsThere were no statistically significant differences among groups in the preoperative anatomical varus angle and Kellgren–Lawrence gonarthrosis classification grade (p=0.139 and p=0.329, respectively). In the coronal plane, the alignment of femoral component (α angle) and tibial component (β angle) was similar in all three groups (α angle, 95.01 vs. 95.14 vs. 94.9, p=0.945; β angle, 90.03 vs. 89.67 vs. 89.98, p=0.483). The sagittal plane alignment of femoral component (γ angle) and tibial component (δ angle) did not show significant differences (γ angle, 7.04 vs. 6.98 vs. 7.00, p=0.132; δ angle, 86.56 vs. 87.41 vs. 86.73, p=0.610).ConclusionsThe angular alignment of components was similar between SBTKA and UTKA.

show abstract

Section: Discussionmentioning

confidence: 98%

Component Alignment in Simultaneous Bilateral versus Unilateral Total Knee Arthroplasty

Qadir¹,

Shah²,

Waqas³

et al. 2019

Knee Surg Relat Res

View full text Add to dashboard Cite

show abstract

“… 34 Notwithstanding this, studies reporting over 20% of outliers have illustrated an insignificant impact of these aberrations over the functional outcomes. 35 Recent data advocates comparable to superior outcomes with kinematic alignment after TKA. 36 …”

Section: Axes Alignment and Malalignment- Their Importance And Implimentioning

confidence: 99%

Extra-articular deformities in arthritic knees-a grueling challenge for arthroplasty surgeons: An evidence-based update

et al. 2018

View full text Add to dashboard Cite

Critical to the success of a total knee arthroplasty (TKA) is the anatomical alignment. This may appear as a challenge in an extra-articular deformity (EAD) that may be inherent in certain people or result from fracture malunion, congenital disorders, nutritional, metabolic and infective causes. This appraisal aimed at providing the reader with an up-todate overview of the research carried out on, and existent evidence of EAD correction while planning a TKA. We reviewed the current English literature on TKA in extra-articular knee deformities. Among the published data, a common initial approach of mandatory clinical and radiological assessment emerges as an obligatory step while handling cases with EAD. While several methods of managing the deformity and arthritis have been described, a broad division into intra-articular and extra-articular means can be deciphered. The relatively old-school, yet reliable thought process of extra-articular correction allows an all-inclusive restoration of alignment with the inherent complications related to the necessary osteotomy. A cohort of younger and more venturesome surgeons seem inclined towards performing navigated, intra-articular correction for mild to moderate and sometimes, severe deformities. The crux of the matter lies is obtaining a well-balanced knee without violating the all-important cruciates. Restoring the patient’s ambulatory status seems sooner with the intra-articular methods which are also more precise in determining the axes and while removing minimum bone. Greatest satisfaction is accomplished in those with less grotesque, rotationallyaligned knees while meticulously balancing soft-tissues and encouraging earlier weightbearing.

show abstract

“…Nevertheless, numerous recent studies have questioned the importance of HKA in restoring the affected limb’s function after TKA [ 5 , 12 – 18 ]. Many other lower-extremity angles of alignment have also been studied for their correlations with clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…Some are part of HKA, such as mechanical medial proximal tibial angle (mMPTA) and coronal femoral angle (CFA); there are also others, such as joint line orientation angle (JLOA) and distal femoral valgus resection (DFVR) [ 18 , 19 ]. However, there is no consensus on which of these angles correlate to clinical outcome in TKA [ 5 , 12 , 20 – 22 ]. Thus, correlations between angles of limb alignments and clinical outcomes should be further clarified.…”

Section: Introductionmentioning

confidence: 99%

How to predict early clinical outcomes and evaluate the quality of primary total knee arthroplasty: a new scoring system based on lower-extremity angles of alignment

Chen

Deng

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background A method that can accurately predict the outcome of surgery can give patients timely feedback. In addition, to some extent, an objective evaluation method can help the surgeon quickly summarize the patient’s surgical experience and lessen dependence on the long wait for follow-up results. However, there was still no precise tool to predict clinical outcomes of total knee arthroplasty (TKA). This study aimed to develop a scoring system to predict clinical results of TKA and then grade the quality of TKA. Methods We retrospectively reviewed 98 primary TKAs performed between April 2013 and March 2017 to determine predictors of clinical outcomes among lower-extremity angles of alignment. Applying multivariable linear-regression analysis, we built Models (i) and (ii) to predict detailed clinical outcomes which were evaluated using the Knee Society Score (KSS). Multivariable logistic-regression analysis was used to establish Model (iii) to predict probability of getting a good clinical outcome (PGGCO) which was evaluated by Knee Injury and Osteoarthritis Outcome Score (KOOS) score. Finally, we designed a new scoring system consisting of 3 prediction models and presented a method of grading TKA quality. Thirty primary TKAs between April and December 2017 were enrolled for external validation. Results We set up a scoring system consisting of 3 models. The interpretations of Model (i) and (ii) were good (R 2 = 0.756 and 0.764, respectively). Model (iii) displayed good discrimination, with an area under the curve (AUC) of 0.936, and good calibration according to the calibration curve. Quality of surgery was stratified as follows: “A” = PGGCO ≥0.8, “B” = PGGCO ≤0.6 but < 0.8, and “C” = PGGCO < 0.6. The scoring system performed well in external validation. Conclusions This study first developed a validated, evidence-based scoring system based on lower-extremity angles of alignment to predict early clinical outcomes and to objectively evaluate the quality of TKA.

show abstract

Prevalence and Predictors of Post-Operative Coronal Alignment Outliers and Their Association With the Functional Outcomes in Navigated Total Knee Arthroplasty

Cited by 15 publications

References 47 publications

Component Alignment in Simultaneous Bilateral versus Unilateral Total Knee Arthroplasty

Component Alignment in Simultaneous Bilateral versus Unilateral Total Knee Arthroplasty

Extra-articular deformities in arthritic knees-a grueling challenge for arthroplasty surgeons: An evidence-based update

How to predict early clinical outcomes and evaluate the quality of primary total knee arthroplasty: a new scoring system based on lower-extremity angles of alignment

Contact Info

Product

Resources

About