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Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees

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Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees

Shinichiro Nakamura, MD, PhD, JAPAN Shota Takemoto, MD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Hiromu Ito, MD, PhD, JAPAN Mutsumi Watanabe, MD, PhD, JAPAN Young Dong Song, MD, PhD, UNITED STATES Shuichi Matsuda, MD, PhD, JAPAN

Kyoto University, Kyoto, Kyoto, JAPAN

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Knee

Anatomic Structure

Bones

Treatment / Technique

Arthroplasty

Summary: When the angle between the mechanical and anatomical axes of the femur is measured in a long leg radiograph, the method to correct the angle according to the patellar ML position can be used to reduce the measurement error, which reflects the proper angle in the true AP view.

Background

A long leg radiograph remains a gold standard during the preoperative planning for the femoral resection, and the angle between the mechanical and anatomical axes is applied to the cutting jig. Lower limb malrotation can be observed in long leg radiographs, affecting the measurement of the angle between the mechanical and anatomical axes. The purposes were to analyze the effect of limb rotation and to evaluate the accuracy of the corrected angle between the mechanical and anatomical axes based on the patellar medial-lateral (ML) position. The hypothesis was that the correction of the angle between the mechanical and anatomical axes according to the patellar ML position can reduce the error from the angle in the true antero-posterior (AP) view in most of the knees.

Materials And Methods

A total of 100 consecutive knees with varus deformity undergoing primary total knee arthroplasty were included. Computed tomography images were digitally reconstructed in the neutral position, and internally and externally rotated at 10° and 20° relative to the mechanical axis of the femur, connecting the center of the femoral head and knee joint, respectively. The patellar ML position relative to the medial (0%) and lateral (100%) epicondyles and the angle between the mechanical and anatomical axes of the femur were measured. The angle between the mechanical and anatomical axes of the femur was measured in each digitally reconstructed image. The corrected angle between the mechanical and anatomical axes was calculated using the averaged translational ratio.

Results

In the neutral position, the patellar center position was 56.1% (standard deviation [SD] = 4.7%), which was 31.4% (SD = 7.2%) and 80.2% (SD = 5.4%) in the 20° internal and external rotation, respectively. The angle between the mechanical and anatomical axes was 2.6° (SD = 2.0°) and 8.1° (SD = 2.1°) in the 20° internal and external rotation, respectively. On average, if the patellar center shifted 10%, the change of the angle between the mechanical and anatomical axes of the femur was 1.13°. The following equation was applied to calculate the corrected angle between the mechanical and anatomical axes of the femur.
z = (56.1 - x) × 0.113 + y
(x: patellar ML position (%), y: measured angle (degrees), z: corrected angle (degrees))
In the 20° external and internal rotations, approximately 40% of the knees showed a discrepancy of >3°. Applying the corrected angle, a discrepancy from the neutral position decreased.

Conclusion

The patellar ML center and the angle between the mechanical and anatomical axes are altered with limb rotation. When the angle between the mechanical and anatomical axes of the femur is measured in a long leg radiograph, the method to correct the angle according to the patellar ML position can be used to reduce the measurement error, which reflects the proper angle in the true AP view.

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"The Other Partial Knee"- Milling System Technique for Patellofemoral Arthroplasty in 250 Patients ePoster Presentation Alexander P. Sah, MD, UNITED STATES
Detection Loosening of Total Knee Arthroplasty Implant from Plain Radiograph Using Machine Learning Algorithm ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty ePoster Presentation Simon W. Young, MD, FRACS, NEW ZEALAND Matthew Carter, NEW ZEALAND Gavin William Clark, MBBS, FRACS, AUSTRALIA Christina Esposito, PhD, AUSTRALIA Matthew Walker, MBChB, FRACS, NEW ZEALAND
Patella in Total Knee Replacement: Patellar Resurfacing has Better Outcomes than Lateral Facetectomy at One Year Follow-Up ePoster Presentation Tomas Alfredo Esteves, MD, ARGENTINA Matias Novillo, MD, ARGENTINA Tomas Nicolino, MD, ARGENTINA Matias Costa-Paz, MD, PhD, ARGENTINA Lisandro Carbó, MD, ARGENTINA Julian Costantini, MD, ARGENTINA
Intra- And Inter-Operator Reliability Assessment Of A Novel Extramedullary Accelerometer-Based Smart Cutting-Guide For Total Knee Arthroplasty: An In-Vivo Study ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Domenico Alesi, MD, ITALY Arcangelo Russo, MD, ITALY Mirco Lo Presti, MD, ITALY Iacopo Sassoli, MD, ITALY Matteo La Verde, MD, ITALY Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY
Golfers Have Greater Preoperative and Equal Postoperative Function When Undergoing Total Knee Arthroplasty Compared to Non-Golfers ePoster Presentation Patrick G Robinson, MBChB, MRCS, MS, MBA, UNITED KINGDOM Robert Kay, MBChB, UNITED KINGDOM Deborah Macdonald, BA(Hons), UNITED KINGDOM Andrew Murray, MBChB, FFSEM, UNITED KINGDOM Nick David Clement, MBBS, MD, PhD, FRCS(Orth), UNITED KINGDOM
Intraoperative Surgeon-Performed vs. Conventional Anesthesiologist-Performed Continuous Adductor Canal Block In Total Knee Arthroplasty: A Randomized Controlled Trial ePoster Presentation Chayut Chaiperm, MD, THAILAND Srihatach Ngarmukos, MD, THAILAND Aree Tanavalee, MD, THAILAND Chotetawan Tanavalee, MD, THAILAND Wirinaree Kampitak, MD, THAILAND
Phenotypic Differences In Coronal Alignment In Robot-Assisted Total Knee Arthroplasty Do Not Affect Patient-Reported Outcome Measurements In A Three-Dimensional Computed Tomography Analysis: A Single-Center Cohort Study ePoster Presentation Takao Kaneko, MD, PhD,, JAPAN Ayakane Yamamoto, MD, JAPAN Kazutaka Takada, MD, JAPAN Shu Yoshizawa, MD, JAPAN Hiroyasu Ikegami, MD, PhD, Prof., JAPAN
Quality of Life Following Primary Total Knee Arthroplasty: Factors Predicting Satisfaction in Low-Income Population ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Houssem Eddine Chahed, MD, TUNISIA Ahmed Zendeoui, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Anis Tebourbi, MD, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
Follow-Up after Primary Total Knee Arthroplasty with the Sigma PFC implant (DePuy Synthes Inc.) in Patients with Metal Allergy or Hypersensitivity ePoster Presentation Natalie Mengis, MD, SWITZERLAND Jules-Nikolaus Rippke, Dr. med. (MD), SWITZERLAND Sebastian Schmidt, GERMANY Tudor Daniel Cucos, MD, GERMANY Luis Alfredo Navas Contreras, MD, GERMANY Daniel Krahl, MD, GERMANY Marcus Streit, Prof., GERMANY
Impact of Femur Correction on the Mechanical Alignment of the Total Knee Prosthesis ePoster Presentation Israel Alejandro Alejandro González Rizo, MD, MEXICO Fidel G Dobarganes, Prof, MEXICO Jorge Negrete Corona, MD, MEXICO Alberto Guevara-Alvarez, MD, MEXICO Franco Garcini Munguia, MD, MEXICO

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Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees

Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees

Background

Materials And Methods

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Conclusion

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Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees

Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees

Background

Materials And Methods

Results

Conclusion

More 2023 ISAKOS Congress Content