Femoral Component Axial Rotation in the Gap-Balancing Approach to Total Knee Arthroplasty: Measurement by Computed Tomography

Femoral Component Axial Rotation in the Gap-Balancing Approach to Total Knee Arthroplasty: Measurement by Computed Tomography

Author Aihara, André Yui Autor UNIFESP Google Scholar
Cardoso, Fabiano Nassar de Castro Autor UNIFESP Google Scholar
Debiex, Pedro Autor UNIFESP Google Scholar
Castro, Antonio M. Autor UNIFESP Google Scholar
Luzo, Marcus Vinicius Malheiros Autor UNIFESP Google Scholar
Fernandes, Artur da Rocha Correa Autor UNIFESP Google Scholar
Abstract Background: Rotational malalignment of total knee arthroplasty (TKA) is a potential cause for revision surgery

therefore, it is important to have valid criteria for evaluation of normal component rotational alignment. Because computed tomography (CT) is considered the most accurate method to assess the rotational alignment of prosthetic components, the objectives in this study were define the femoral component (FC) rotation by measuring the posterior condylar angle (PCA) and the condylar twist angle (CTA) in a patient population that underwent gap-balancing TKA

determine the reliability of the FC rotation by using these measurements

evaluate the inter-relationship between the PCA and CTA

and finally evaluate the frequency and agreement in identification of the medial epicondyle sulcus (MES). Methods and Results: In this retrospective study, 2 radiologists examined 50 CT scans. Mean PCA values of -2.26 degrees and -2.56 degrees (internal rotation) and CTA values of -5.54 degrees and -6.28 degrees (internal rotation) were attained by 2 observers with a higher interobserver concordance for the PCA. Both measurements were considered to be reliable. There was moderate interobserver agreement for MES identification, with the MES present in 64% and 78% of patients, as identified by 2 observers. Conclusion: Mean FC rotation values as evaluated by PCA were -2.26 degrees and -2.56 degrees and as evaluated by CTA were -5.54 degrees and -6.28 degrees. PCA and CTA measurement by CT is reliable

however, the use of PCA is preferable because of the higher observer concordance. PCA can be inferred by subtracting 3 degrees or 4 degrees from the CTA. MES was identified in 64% and 78% of patients, with only moderate interobserver agreement. (c) 2017 Elsevier Inc. All rights reserved.
Keywords knee arthroplasty
gap-balancing approach
femoral component rotation
CT scan
diagnostic imaging
orthopedic procedures
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Date 2018
Published in Journal Of Arthroplasty. Philadelphia, v. 33, n. 4, p. 1222-1230, 2018.
ISSN 0883-5403 (Sherpa/Romeo, impact factor)
Publisher Churchill Livingstone Inc Medical Publishers
Extent 1222-1230
Origin http://dx.doi.org/10.1016/j.arth.2017.10.038
Access rights Closed access
Type Article
Web of Science ID WOS:000430059700045
URI https://repositorio.unifesp.br/handle/11600/55713

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