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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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How to Measure Physical Function in Clinical Trials on Patients Undergoing Total or Partial Knee Arthroplasty? A Systematic Review ePoster Presentation Marco Adriani, MD, ITALY Roland Becker, MD, PhD, Prof., GERMANY Aleksandra Krolikowska, PhD, Prof., POLAND Krzysztof Lachowski, MD, GERMANY Robert Prill, PhD, GERMANY
Same Complication Rate After Day-Case Procedure Or Fast-Track Procedure After Total Hip And Knee Arthroplasty. A Prospective, Propensity Score-Matched Case-Control Study ePoster Presentation Jean-Yves Jenny, Prof., FRANCE Vincent Gisonni, MD, FRANCE
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
Preoperative Bone Marrow Edema Negatively Impacts Intermediate to Long-Term Outcomes after Unicompartmental Knee Arthroplasty ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY
Antibiotic-Loaded Bone Cement with Colistin at Erythromycin Do Not Decrease Chronic TKA Pji at a Long-Term ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Pedro Hinarejos, MD, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Modular Knee Arthrodesis as Definitive Treatment for Periprosthetic Infection, Bone Loss, and Failure of the Extensor Mechanism after Total Knee Arthroplasty ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Maksym Bartashevskyy, BA, UNITED STATES Zachary Berliner, MD, UNITED STATES Ruijia Niu, MPH, UNITED STATES James V. Bono, MD, UNITED STATES Ayesha Abdeen, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES
Short Term Outcome of Tibial Defect Reconstruction In Primary Total Knee Arthroplasty: A Retrospective Study ePoster Presentation Sanjib Kumar Behera, MS (Orth), DNB (Rehab), DPMR, INDIA Madhumita Pradhan, BDS, MPH, MHA , INDIA Vikram Choudhary, MD, UNITED STATES
Calipered Measurements Method For Kinematically Aligned Total Knee Arthroplasty Has A Risk Of Excessive Varus Cut For The Proximal Tibia In Japanese Varus Knees ePoster Presentation Umit Kuwa, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Junya Itou, MD, PhD, JAPAN Ken Okazaki, MD, PhD, JAPAN
Does 1000 Mg Ferric Carboxylate Maltose Have an Additional Benefit on the Haemoglobin Recovery Post Total Knee Arthroplasty? - A Comparison with 500 Mg of Ferric Carboxymaltose ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Ashwini Khokhar, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Naveen Chandar, MBBS, INDIA Abhinav Mishra, MS, DNB, INDIA Rajesh Maniar, INDIA
Factors Associated With Failure and Survivorship Following Unicompartmental Knee Arthroplasty: A Single-Center Experience ePoster Presentation Anirudh K Gowd, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES Asher Lichtig, MD, UNITED STATES Orhan Yanmis, MD, UNITED STATES Gary G. Poehling, MD, UNITED STATES
Tibia Placement Difference Between The Supine And Prone Position After Total Knee Arthroplasty: The Comparison Of The BCS and PS-TKA ePoster Presentation Takanori Iriuchishima, MD, PhD, JAPAN Keinosuke Ryu, Prof., JAPAN Eiji Cho, MD, JAPAN
Palliative Arthroscopic Debridement with Continuous Irrigation for the Infection TKA of High Mortality Risk Patients ePoster Presentation Yoon Sang Jeon, MD, KOREA, REPUBLIC OF Sung-Sahn Lee, MD., PhD., KOREA, REPUBLIC OF Yoon Cheol Nam, MD, KOREA, REPUBLIC OF Dong Jin Ryu, MD, PhD., KOREA, REPUBLIC OF
A Prospective Randomised Study to Compare the Clinical and Radiological Outcomes of Functionally Aligned versus Mechanically Aligned Total Knee Arthroplasty with Robotic Arm Assistance ePoster Presentation Jai Thilak Kailathuvalapil, MS, MCh, FRCS, INDIA Amal Antony Paul, MBBS, INDIA

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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