Roentgenographic Assessment of the Hip???Knee???Ankle Axis in Medial Gonarthrosis

Odenbring, Sten; Berggren, Ann-Marie; Peil, Lars

doi:10.1097/00003086-199304000-00027

Cited by 74 publications

(62 citation statements)

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“…Measurements of the HKA angle were taken with the knee in slight flexion, and the values obtained were reasonably reproducible. 20,21 A true lateral radiograph was obtained by superimposing one femoral condyle over the other, and the anteroposterior projection was taken at 90° to this lateral plane. We calculated HKA angles using a ruler frame and a full-length radiograph which showed both hip and ankle, drawing lines from the centre of the femoral head and from the centre of the tibial surface of the ankle to the midpoint between the spines of the tibial eminence.…”

Section: Methodsmentioning

confidence: 99%

Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee

Magyar¹,

Ahl

Vibe

et al. 1999

The Journal of Bone and Joint Surgery. British volume

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Medial osteoarthritis of the knee is associated with varus deformity and an abnormal load through the medial compartment. Proximal tibial osteotomy can restore the mechanical axis and correct the abnormal load.1,2 Good long-term results depend on the ultimate correction, which is ideally 2° to 8° of valgus of the mechanical axis. [3][4][5][6] There are several reports of good results achieved by closedwedge osteotomy, 3-5,7-9 but this procedure is technically demanding. The outcome is unpredictable and the period of convalescence lengthy. 7,9-11 In addition, access to the lateral compartment may be difficult after previous tibial osteotomy, 12,13 and even in the younger age group some surgeons carry out a primary arthroplasty rather than an osteotomy. 14-16 Open-wedge osteotomy by hemicallotasis (HCO) is simpler and requires a shorter rehabilitation period. 17,18We have compared in a randomised, prospective study the results and complications of closed-wedge high tibial osteotomy (HTO) and HCO. Patients and MethodsWe randomly allocated 46 patients (14 women and 32 men) to either HTO (n = 25) or HCO (n=25). The two groups were similar in age, gender, preoperative grade of arthritis and hip-knee-ankle angle (HKA) ( Table I). The median age was 55 years (40 to 68) in the HTO group and 55 years (38 to 64) in the HCO group. The median range of movement was 125° (105 to 140) in the HTO group and 130° (90 to 150) in the HCO group. Bilateral surgery was carried out on four patients, one of whom was randomised to HTO on both sides. The other three had HTO on one side and HCO on the other. There was a median interval of nine months (2.5 to 14) between the two operations. Surgeons of equal experience and skill carried out the procedures.The indication for surgery was pain in younger, active patients with medial arthritis of grade 1 to 3. 19 We aimed to achieve an overcorrection to an HKA of 4° of valgus in both groups. The correction of 4 ± 2° of valgus was considered optimal.

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Section: Methodsmentioning

confidence: 99%

Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee

Magyar¹,

Ahl

Vibe

et al. 1999

The Journal of Bone and Joint Surgery. British volume

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“…This system has high reproducibility with high inter-and intraobserver reliability [14,17]. Our study found significant differences between navigation data and post-operative weight-bearing X-rays.…”

Section: Discussionmentioning

confidence: 78%

“…Assuming flawless landmarking, it could well be the navigation data. However, the uncertainty of the landmarking accuracy makes the X-ray data more reproducible [14,17]. Bäthis et al demonstrated intra-operative cutting errors in the coronal and sagittal planes that were caused by technique and instrumentation.…”

Section: Discussionmentioning

confidence: 99%

Deviations between intra-operative navigation data and post-operative weight-bearing X-rays

Livshetz¹,

Brin

Holcroft

et al. 2010

Computer Aided Surgery

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Several studies have shown that computer-navigated TKA reduces the rate of outliers. Thirty-one consecutive patients were operated on by the same surgeon using a computer assisted navigation system. Data collected by the system included the final mechanical axis of the extremity (HKA angle) and the coronal angle of the tibial and femoral implants. These same values were measured using CAD software on full weight-bearing long X-rays taken 6 weeks post-surgery. Deviations were observed when X-ray measurements were compared to intra-operative data collected from the navigation system. A statistically significant difference was found in the tibial cut (1.29 AE 1.35 ; p < 0.0001) and in the HKA (1.59 AE 2.36 ; p ¼ 0.0007). Outliers of more than 3 were observed in the coronal plane of the tibial implant in 9.6% of patients, in the coronal plane of the femoral implant in 6.4% of patients, and in the HKA angle of 29% of patients. Our results indicate that the use of navigation alone is insufficient to prevent outliers beyond an acceptable range of 3 .

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“…Limb alignment was expressed as the femorotibial angle (FTA) obtained from the anteroposterior whole-leg radiograph, which showed high reproducibility [27]. The FTA was measured using Fujifilm OP-A software (Fujifilm, Co Ltd, Tokyo, Japan) with a measurement accuracy of one decimal [31].…”

Section: Radiographymentioning

confidence: 99%

Predictive factors for the progression of spontaneous osteonecrosis of the knee

Akamatsu

Kobayashi

Kusayama

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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Roentgenographic Assessment of the Hip???Knee???Ankle Axis in Medial Gonarthrosis

Cited by 74 publications

References 0 publications

Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee

Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee

Deviations between intra-operative navigation data and post-operative weight-bearing X-rays

Predictive factors for the progression of spontaneous osteonecrosis of the knee

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