Three-Dimensional Evaluation Of Distal Femoral Valgus Angle Using Whole Leg CT In Total Knee Arthroplasty

Three-Dimensional Evaluation Of Distal Femoral Valgus Angle Using Whole Leg CT In Total Knee Arthroplasty

Atsushi Sato, MD, PhD, JAPAN Marika Mukunoki, MD, JAPAN Takayuki Koya, MD, PhD, JAPAN Misako Takizawa, MD, JAPAN Reo Nagasaka, JAPAN Kanako Izukashi, MD, JAPAN Masataka Ota, MD, JAPAN Jun Oike, MD, PhD, JAPAN Takayuki Okumo, MD, PhD, JAPAN Saki Yagura, MD, JAPAN Koji Kanzaki, Prof., JAPAN

Showa University Fujigaoka Hospital, Yokohama, Kanagawa, JAPAN


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Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Patient Populations

Diagnosis Method

Sports Medicine


Summary: Three-Dimensional Evaluation of Distal Femoral Valgus Angle Using Whole Leg CT in Total Knee Arthroplasty


Introduction

Proper implant positioning is important to get suitable leg alignment in total knee arthroplasty (TKA). However, the three-dimensional evaluation of accurate lower limb alignment is still controversial.

Purpose

Therefore, we performed a three-dimensional evaluation of the distal femoral valgus angle (DFVA) using full-leg CT before TKA.

Methods

Consecutive 372 patients (282 females, 90 males, mean age: 74.8 y.o), yielded 512 knees were included in this study. CT-based patient-specific 3D femur model by ZedKnee software (LEXI) was used to define a mechanical axis and distal anatomical axis of the femur. The case where the angle deviates from the DFVA by ± 3 ° was defined as the outlier, and the ratio of the outlier was evaluated.

Results

The average DFVA was 6.0 ± 2.2 °, of which outliers were found in 89 knees (17.4%). Of the outliers, 38 (7.4%) had DFVA less than 3 ° and 51 (6.1%) had greater than 9 °.

Conclusion

It should be noted that the same cutting angle for performing the distal femoral bone cut in TKA may lead to improper placement of the femoral component.