2023 ISAKOS Biennial Congress ePoster
An Investigation into the Relationship of Whiteside’s Line and the Transepicondylar Axis of Knee. Does Whiteside’s Line Predict the Transepicondylar Axis of the Knee During Knee Replacement?
Tisse Siriwardena, Md MCh, Sligo, Co. Sligo IRELAND
Paraic A. Murray, FRCS(Orth), Galway IRELAND
Galway Clinic, Galway, Galway, IRELAND
FDA Status Not Applicable
Summary
This study questions the perpendicular relationship between Whitesideline (WL) and Transepicondylor Axis (TA) and the unreliability of WL to predict the implants TA during Total knee arthroplasty(TKA).
ePosters will be available shortly before Congress
Abstract
Background
Total knee arthroplasty (TKA) is the final form of treatment for an osteoarthritic knee.Successful TKA should manifest a correct rotational fixation of the femoral implant. This requires identifying the anatomical landmarks and a parallel fixation of the component to its anatomical transepicondylar axis (ATA) or transepicondylar axis (TA). Whiteside reported that TA(ATA) and Whiteside’s line (WL) were perpendicular. In the measured resection technique of TKA, posterior condyles are used to seek the estimated anatomical transepicondylar axis (EATA).
A comparison of these landmarks was carried out with variables to see their reliability in achieving correct rotation.
Methods
A retrospective study of a consecutive case series of (n=880) patients from May 2017 to February 2021 was conducted. EATA obtained from the instrumentation was mapped against the ATA obtained from WL. Femoral rotation was calculated using inverse tangent (?°). Descriptive and inferential statistical analyses were conducted among variables.
Result:
The sample mean angle of ?° between the TA(ATA) and EATA was -3.57° ± 0.49° a SD of 7.30°. Range of +25.78° to -22.92°. From the sample population, 446 females (53.2%) presented with ?° -2.43° (SD 7.16°) and 393 (46.8%) with ?° of 5.73° (SD 7.24°) were males. There were 400 TKA’s from the sample (47.7%) which were left knees with ?° -2.69 (SD 7.51°) and 438 patients
(52.3%) with ?° of -4.31° (SD 7.03°) were right knees. 190 patients (22.26%) had undergone TKA with ?° -2.69 (SD 7.58°) who had osteoarthritis in all compartments. 139 patients (18.8%) with ?° -3.5 (SD 6.8°) were absent ACL. 726 (82.5%) with ?° -3.6 (SD 7.4°) were intact ACL and 15 patients (1.7%) of the population with ?° -2.7 (SD 5.78°) were ruptured ACL.
Conclusion
85.22% shows significant findings and only 14.78% of the population observed had no
variation. Significant findings were noted in all presenting variables, which questions the perpendicular relationship between WL and TA(ATA) and the unreliability of WL to predict the implants TA(ATA) during TKA.