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Accuracy of the Component Alignment and Sizing in Total Knee Arthroplasty: Preoperative Templating and Postoperative Evaluation Using CT-Based 3D Pre-Operative Planning Software

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Accuracy of the Component Alignment and Sizing in Total Knee Arthroplasty: Preoperative Templating and Postoperative Evaluation Using CT-Based 3D Pre-Operative Planning Software

Takayuki Koya, MD, PhD, JAPAN Atsushi Sato, MD, PhD, JAPAN Jun Oike, MD, PhD, JAPAN Masataka Ota, MD, JAPAN Kanako Izukashi, MD, JAPAN Takayuki Okumo, MD, PhD, JAPAN Saki Yagura, MD, JAPAN Naoki Okuma, MD, JAPAN Fumiyoshi Kawashima, MD, JAPAN Hiroshi Takagi, MD, PhD, JAPAN Koji Kanzaki, Prof., JAPAN

Department of Orthopaedic Surgery, Showa University Koto Toyosu Hospital, Tokyo, JAPAN

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Knee

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Total Joint Replacement

Patient Populations

Elderly

Diagnosis Method

CT-Scan

Summary: CT-based 3D pre-operative planning software(ZedKnee; LEXI) could help place TKA components more accurately

Background

Accurate component placement and good ligament balance are essential in total knee arthroplasty (TKA). The conventional mainstream technique of preoperative templating and postoperative evaluation in TKA were mainly performed based on two-dimensional X-ray images. However, three-dimensional templating and evaluation using CT or MRI data have recently become more common, which enables them to be more accurate. Hence, the purpose of this study was to evaluate the preoperative templating and postoperative accuracy of the component alignment and sizing in TKA using CT-based 3D pre-operative planning software (ZedKnee; LEXI, Tokyo, Japan)

Methods

We retrospectively included 150 patients, 219 knees (115 females, 35 males; 75.1±7.5 years old on average), who underwent primary TKA using Posterior Stabilized Fixed Bearing of ATTUNE (Depuy Synthes, Warsaw, IN, USA) at our institute in July 2015 to December 2020. We imported preoperative and three-day postoperative DICOM data of whole-leg CT from the hip joints to the ankle joints into ZedKnee software for preoperative templating and postoperative evaluation, respectively, and assessed pre and postoperative component size matching rate and component alignment accuracy.

Results

The femoral and tibial component size concordance rate was 71.7% (157/219) and 66.8% (144/219), respectively. Postoperative femoral and tibial components were placed at 2.2±2.2° varus against the 3D mechanical axis, 0.4±2.8° extended, and 3.9±2.2° externally rotated against the posterior condylar axis (PCA), and 0.8±1.9° varus, 4.3±2.2° tilted posteriorly, and 7.0±7.1° internally rotated, respectively.

Conclusion

According to our postoperative evaluation, using 3D planning software in the preoperative planning of TKA could help result in good component placement. However, there was a tendency for the femoral component to be placed with a slight varus and the tibial component to be internally rotated, which showed greater variability compared to the previous studies. Therefore, the results indicate that further improvement and refinement of intraoperative techniques are needed to reflect preoperative planning more accurately.

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Large Reduction In Postoperative Posterior Tibial Slope Risks Anterior Collapse Of The Tibial Component In Fixed-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Kazuhisa Hatayama, MD, PhD, JAPAN Masanori Terauchi, MD, JAPAN Shingo Kurihara, MD, JAPAN Satoshi Nonaka, MD, JAPAN Hibiki Kakiage, MD, JAPAN
Patient Satisfaction and Functional outcomes in a Latin American cohort: Comparative Study Between Conventional Technique vs. Robotic Arm Assistance. ePoster Presentation Rafael Calvo, MD, CHILE Maria Loreto Figueroa Berrios, MD, CHILE Rodrigo Guiloff, MD, Prof, CHILE Zoy Anastasiadis, MD, CHILE David H. Figueroa, MD, CHILE
"The Other Partial Knee"- Milling System Technique for Patellofemoral Arthroplasty in 250 Patients ePoster Presentation Alexander P. Sah, MD, UNITED STATES
Short-Term Clinical Outcome Of Functionally Aligned Robotic-Assisted BCS TKA is Better Than That Of Mechanically Aligned Navigation-Assisted BCS TKA ePoster Presentation Daisuke Hamada, MD, PhD, JAPAN Keizo Wada, MD, JAPAN Yasuaki Tamaki, MD, JAPAN Yasuyuki Omichi, MD, JAPAN Tomohiro Goto, MD, PhD, JAPAN Koichi Sairyo, MD, PhD, JAPAN
Bilateral Simultaneous Unicompartimental Knee Arthroplasty. Midterm Results in 86 Arthroplasties with an Average Follow-Up Of 6.2 Years ePoster Presentation Stefano Gaggiotti, MD, ARGENTINA Gabriel Gaggiotti, MD, ARGENTINA Santino Gaggiotti, MD, ARGENTINA Julio Cesar Ringa
Intraoperative Varus-Valgus Joint Laxity Pattern Was Associated With Postoperative Knee Flexion Angle and Patient-Reported Outcome Measures in Bicruciate-Stabilized Total Knee Arthroplasty. ePoster Presentation Ryota Yamagami, MD, JAPAN Kenichi Kono, MD, PhD, JAPAN Kohei Kawaguchi, MD, PhD, JAPAN Tomofumi Kage, JAPAN Ryo Murakami, MD, JAPAN Takahiro Arakawa, MD, JAPAN Hiroshi Inui, PhD, JAPAN Shuji Taketomi, MD, PhD, JAPAN Sakae Tanaka, MD, PhD, JAPAN
Central Sensitization is Associated with Persistent Postoperative Pain and Inferior Patient-Reported Outcomes in Patients Undergoing Unicompartmental Knee Arthroplasty ePoster Presentation Yong In, 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 Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF
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
Clinical Comparison and Survival Rate Between Unicompartmental Knee Arthroplasty and High Tibial Osteotomy With An External Fixator For Varus Knee In Patients Younger Than 60 Years at Mid-Term Follow-Up ePoster Presentation Amit Kumar Yadav, M.S (Orth),DNB(Orth),MNAMS, UNITED KINGDOM Riccardo D'Ambrosi, MD, ITALY Mangal Parihar, MS Ortho, INDIA
Bicruciate Substituting Total Knee Arthroplasty Improved Anteroposterior Displacement in Mid-Flexion Range ePoster Presentation Keinosuke Ryu, Prof., JAPAN Takanori Iriuchisima, MD, JAPAN
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

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Accuracy of the Component Alignment and Sizing in Total Knee Arthroplasty: Preoperative Templating and Postoperative Evaluation Using CT-Based 3D Pre-Operative Planning Software

Accuracy of the Component Alignment and Sizing in Total Knee Arthroplasty: Preoperative Templating and Postoperative Evaluation Using CT-Based 3D Pre-Operative Planning Software

Background

Methods

Results

Conclusion

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Accuracy of the Component Alignment and Sizing in Total Knee Arthroplasty: Preoperative Templating and Postoperative Evaluation Using CT-Based 3D Pre-Operative Planning Software

Accuracy of the Component Alignment and Sizing in Total Knee Arthroplasty: Preoperative Templating and Postoperative Evaluation Using CT-Based 3D Pre-Operative Planning Software

Background

Methods

Results

Conclusion

More 2023 ISAKOS Congress Content