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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2012

01.12.2012 | Knee

CT measurements prior to computer-assisted total knee arthroplasty do not improve rotational placement of the femoral component

verfasst von: A. de Ladoucette

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 12/2012

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Abstract

Purpose

The aim of this study is to determine whether computer-assisted surgery (CAS) can gain more precision by utilizing information from pre-operative computed tomography (CT).

Methods

Sixty-five patients undergoing total knee arthroplasty in 2008 were included. On pre- and post-operative CT, epicondylar and posterior condylar lines were drawn and the posterior condylar angle between these two lines measured. During the surgery, epicondylar and posterior condylar lines were also registered before and after CAS-guided cuts were made. CAS was used to fix the orientation of the cutting guide on the distal femur at 3° of external rotation from the posterior condylar line.

Results

There was no correlation between CT measurements and CAS measurements. All orientations of the lines (relative to the horizontal) and angles measured using CT were significantly different (p < 0.05).

Conclusion

No relationship was found between pre-operative CT measurements and peri-operative CAS measurements used to orient the femoral component. Data obtained from CT cannot be used peri-operatively with CAS to improve rotational setting of the femoral component.

Level of evidence

Therapeutic study, Level II.
Literatur
1.
Zurück zum Zitat Akagi M, Matsusue Y, Mata T, Asada Y, Horiguchi M, Lida M, Nakamura T (1999) Effect of rotational alignment on patellar tracking in total knee arthroplasty. Clin Orthop Relat Res 366:155–163PubMedCrossRef Akagi M, Matsusue Y, Mata T, Asada Y, Horiguchi M, Lida M, Nakamura T (1999) Effect of rotational alignment on patellar tracking in total knee arthroplasty. Clin Orthop Relat Res 366:155–163PubMedCrossRef
2.
Zurück zum Zitat Anouchi YS, Whiteside LA, Kaiser AD, Milliano MT (1993) The effects of axial rotational alignment of the femoral component on knee stability and patellar tracking in total knee arthroplasty demonstrated on autopsy specimens. Clin Orthop Relat Res 287:170–177PubMed Anouchi YS, Whiteside LA, Kaiser AD, Milliano MT (1993) The effects of axial rotational alignment of the femoral component on knee stability and patellar tracking in total knee arthroplasty demonstrated on autopsy specimens. Clin Orthop Relat Res 287:170–177PubMed
3.
Zurück zum Zitat Arima J, Whiteside LA, Mccarthy DS, White SE (1995) Femoral rotational based on the anteroposterior axis, in total knee arthroplasty in a valgus knee. A technical note. J Bone Joint Surg Am 77:1331–1334PubMed Arima J, Whiteside LA, Mccarthy DS, White SE (1995) Femoral rotational based on the anteroposterior axis, in total knee arthroplasty in a valgus knee. A technical note. J Bone Joint Surg Am 77:1331–1334PubMed
4.
Zurück zum Zitat Bargren JH, Blaha JD, Freemanf MA (1983) Alignment in total knee arthroplasty. Correlated biomechanical and clinical observations. Clin Orthop Relat Res 173:178–183PubMed Bargren JH, Blaha JD, Freemanf MA (1983) Alignment in total knee arthroplasty. Correlated biomechanical and clinical observations. Clin Orthop Relat Res 173:178–183PubMed
5.
Zurück zum Zitat Berger RA, Crossett LS, Jacobs JJ, Rubash HE (1998) Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res 356:144–153PubMedCrossRef Berger RA, Crossett LS, Jacobs JJ, Rubash HE (1998) Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res 356:144–153PubMedCrossRef
6.
Zurück zum Zitat Boisrenoult P, Scemama P, Fallet L, Beaufils P (2001) La torsion epiphysaire distale du fémur dans le genou arthrosique. Rev Chir Orthop Reparatrice Appar Mot 87:469–476PubMed Boisrenoult P, Scemama P, Fallet L, Beaufils P (2001) La torsion epiphysaire distale du fémur dans le genou arthrosique. Rev Chir Orthop Reparatrice Appar Mot 87:469–476PubMed
7.
Zurück zum Zitat Bolognesi M, Hofmann A (2005) Computer navigation versus standard instrumentation for tka: a single surgeon experience. Clin Orthop Relat Res 440:162–169PubMedCrossRef Bolognesi M, Hofmann A (2005) Computer navigation versus standard instrumentation for tka: a single surgeon experience. Clin Orthop Relat Res 440:162–169PubMedCrossRef
8.
Zurück zum Zitat Chauhan SK, Scott RG, Breidahl W, Beaver RJ (2004) Computer-assisted knee arthroplasty versus a conventional jig-based technique a randomised, prospective trial. J Bone Joint Surg Br 86:372–377PubMedCrossRef Chauhan SK, Scott RG, Breidahl W, Beaver RJ (2004) Computer-assisted knee arthroplasty versus a conventional jig-based technique a randomised, prospective trial. J Bone Joint Surg Br 86:372–377PubMedCrossRef
9.
Zurück zum Zitat Churchill DL, Incavo SJ, Johnson CC, Beynnon BD (1998) The transepicondylar axis approximates the optimal flexion axis of the knee. Clin Orthop Relat Res 356:111–118PubMedCrossRef Churchill DL, Incavo SJ, Johnson CC, Beynnon BD (1998) The transepicondylar axis approximates the optimal flexion axis of the knee. Clin Orthop Relat Res 356:111–118PubMedCrossRef
10.
Zurück zum Zitat Eckhoff DG, Bach JM, Spitzer VM, Reinig KD, Bagur MM, Baldini TH, Rubinstein DR, Humphries S (2003) Three-dimensional morphology and kinematics of the distal part of the femur viewed in virtual reality. J Bone Joint Surg Am 85(Suppl 4):97–104PubMed Eckhoff DG, Bach JM, Spitzer VM, Reinig KD, Bagur MM, Baldini TH, Rubinstein DR, Humphries S (2003) Three-dimensional morphology and kinematics of the distal part of the femur viewed in virtual reality. J Bone Joint Surg Am 85(Suppl 4):97–104PubMed
11.
Zurück zum Zitat Fehring TK (2000) Rotational malalignment of the femoral component in total knee arthroplasty. Clin Orthop Relat Res 380:72–79PubMedCrossRef Fehring TK (2000) Rotational malalignment of the femoral component in total knee arthroplasty. Clin Orthop Relat Res 380:72–79PubMedCrossRef
12.
Zurück zum Zitat Galaud B, Beaufils P, Michaut M, Abadie P, Fallet L, Boisrenoult P (2008) Torsion distale fémorale du genou: comparaison de la mesure par tomodensitométrie et par navigation peropératoire au cours des arthroplasties totales de genou. A propos de 70 cas. Rev Chir Orthop Reparatrice Appar Mot 94:573–579PubMedCrossRef Galaud B, Beaufils P, Michaut M, Abadie P, Fallet L, Boisrenoult P (2008) Torsion distale fémorale du genou: comparaison de la mesure par tomodensitométrie et par navigation peropératoire au cours des arthroplasties totales de genou. A propos de 70 cas. Rev Chir Orthop Reparatrice Appar Mot 94:573–579PubMedCrossRef
13.
Zurück zum Zitat Hernandez RJ, Tachdjian MO, Poznanski AK, Dias LS (1981) CT determination of femoral torsion. Am J Radiol 137:97–102 Hernandez RJ, Tachdjian MO, Poznanski AK, Dias LS (1981) CT determination of femoral torsion. Am J Radiol 137:97–102
14.
Zurück zum Zitat Jenny JY, Boeri C (2001) Implantation d’une prothèse totale de genou assistée par ordinateur. Rev Chir Orthop Reparatrice Appar Mot 87:645–652PubMed Jenny JY, Boeri C (2001) Implantation d’une prothèse totale de genou assistée par ordinateur. Rev Chir Orthop Reparatrice Appar Mot 87:645–652PubMed
15.
Zurück zum Zitat Jenny JY, Boeri C (2004) Low reproducibility of the intra-operative measurement of the transepicondylar axis during total knee replacement. Acta Orthop 75:74–77CrossRef Jenny JY, Boeri C (2004) Low reproducibility of the intra-operative measurement of the transepicondylar axis during total knee replacement. Acta Orthop 75:74–77CrossRef
16.
Zurück zum Zitat Katz MA, Beck TD, Silber JS, Seldes RM, Lotke PA (2001) Determining femoral rotational alignment in total knee arthroplasty. Reliability of techniques. J Arthroplasty 16:301–305PubMedCrossRef Katz MA, Beck TD, Silber JS, Seldes RM, Lotke PA (2001) Determining femoral rotational alignment in total knee arthroplasty. Reliability of techniques. J Arthroplasty 16:301–305PubMedCrossRef
17.
Zurück zum Zitat Kim YK, Kim JS, Choi Y, Kwon OR (2009) Computer-assisted surgical navigation does not improve the alignment and orientation of the components in total knee arthroplasty. J Bone Joint Surg Am 91:14–19PubMedCrossRef Kim YK, Kim JS, Choi Y, Kwon OR (2009) Computer-assisted surgical navigation does not improve the alignment and orientation of the components in total knee arthroplasty. J Bone Joint Surg Am 91:14–19PubMedCrossRef
18.
Zurück zum Zitat Lehnen K, Giesinger K, Warschkow R, Porter M, Koch E, Kuster M (2011) Clinical outcome using a ligament referencing technique in CAS versus conventional technique. Knee Surg Sports Traumatol Arthrosc 19:887–892PubMedCrossRef Lehnen K, Giesinger K, Warschkow R, Porter M, Koch E, Kuster M (2011) Clinical outcome using a ligament referencing technique in CAS versus conventional technique. Knee Surg Sports Traumatol Arthrosc 19:887–892PubMedCrossRef
19.
Zurück zum Zitat Lützner J, Krummenauer F, Wolf C, Günther KP, Kirschner S (2008) Computer-assisted and conventional total knee replacement a comparative, prospective, randomised study with radiological and ct evaluation. J Bone Joint Surg Br 90:1039–1044PubMedCrossRef Lützner J, Krummenauer F, Wolf C, Günther KP, Kirschner S (2008) Computer-assisted and conventional total knee replacement a comparative, prospective, randomised study with radiological and ct evaluation. J Bone Joint Surg Br 90:1039–1044PubMedCrossRef
20.
Zurück zum Zitat Mahboubi S, Horstmann H (1986) Femoral torsion: ct measurement. Radiology 160:843–847PubMed Mahboubi S, Horstmann H (1986) Femoral torsion: ct measurement. Radiology 160:843–847PubMed
21.
Zurück zum Zitat Michaut M, Beaufils P, Galaud B, Abadiea P, Boisrenoult P, Fallet L (2008) Rotation fémorale par navigation sur la base d’un scanner pré-opératoire dans l’arthroplastie totale de genou: a propos de 70 cas. Rev Chir Orthop Reparatrice Appar Mot 94:580–584PubMedCrossRef Michaut M, Beaufils P, Galaud B, Abadiea P, Boisrenoult P, Fallet L (2008) Rotation fémorale par navigation sur la base d’un scanner pré-opératoire dans l’arthroplastie totale de genou: a propos de 70 cas. Rev Chir Orthop Reparatrice Appar Mot 94:580–584PubMedCrossRef
22.
Zurück zum Zitat Mizu-Uchi H, Matsuda S, Miura H, Okazaki K, Akasaki Y, Iwamoto Y (2008) The evaluation of postoperative alignment in total knee replacement using a ct-based navigation system. J Bone Joint Surg Br 90:1025–1031PubMedCrossRef Mizu-Uchi H, Matsuda S, Miura H, Okazaki K, Akasaki Y, Iwamoto Y (2008) The evaluation of postoperative alignment in total knee replacement using a ct-based navigation system. J Bone Joint Surg Br 90:1025–1031PubMedCrossRef
23.
Zurück zum Zitat Nagamine R, Miura Inoue (1998) Reliability of the antero posterior axis and the posterior condylar axis for determining rotational alignment of the femoral component in TKA. J Orthop Sci 3:194–198PubMedCrossRef Nagamine R, Miura Inoue (1998) Reliability of the antero posterior axis and the posterior condylar axis for determining rotational alignment of the femoral component in TKA. J Orthop Sci 3:194–198PubMedCrossRef
24.
Zurück zum Zitat Richard A, Berger RA, Rubash HE, Seel MJ, Thompsoann WH, Crossett LE (1993) Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res 86:40–47 Richard A, Berger RA, Rubash HE, Seel MJ, Thompsoann WH, Crossett LE (1993) Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res 86:40–47
25.
Zurück zum Zitat Stiehl JB, Abbott BD (1995) Morphology of the transepicondylar axis and its application in primary and revision total knee arthroplasty. J Arthroplasty 10:785–789PubMedCrossRef Stiehl JB, Abbott BD (1995) Morphology of the transepicondylar axis and its application in primary and revision total knee arthroplasty. J Arthroplasty 10:785–789PubMedCrossRef
26.
Zurück zum Zitat Stöckl B, Nogler M, Rosiek R, Fischer M, Krismer M, Kessler O (2004) Navigation improves accuracy of rotational alignment in total knee arthroplasty. Clin Orthop Relat Res 426:180–186PubMedCrossRef Stöckl B, Nogler M, Rosiek R, Fischer M, Krismer M, Kessler O (2004) Navigation improves accuracy of rotational alignment in total knee arthroplasty. Clin Orthop Relat Res 426:180–186PubMedCrossRef
27.
Zurück zum Zitat Suter T, Zanetti M, Schmid M, Romero J (2006) Reproducibility of measurement of femoral component rotation after total knee arthroplasty using computer tomography. J Arthroplasty 21:744–748PubMedCrossRef Suter T, Zanetti M, Schmid M, Romero J (2006) Reproducibility of measurement of femoral component rotation after total knee arthroplasty using computer tomography. J Arthroplasty 21:744–748PubMedCrossRef
28.
Zurück zum Zitat Terukina M, Fujioka H, Yoshiya S, Kurosaka M, Makino T, Matsui N, Tanaka J (2003) Analysis of the thickness and curvature of articular cartilage of the femoral condyle. Arthroscopy 19:969–973PubMedCrossRef Terukina M, Fujioka H, Yoshiya S, Kurosaka M, Makino T, Matsui N, Tanaka J (2003) Analysis of the thickness and curvature of articular cartilage of the femoral condyle. Arthroscopy 19:969–973PubMedCrossRef
29.
Zurück zum Zitat Victor J, Van Doninck D, Labey L, Van Glabbeek F, Parizel P, Bellemans J (2009) A common reference frame for describing rotational alignment of the distal femur. J Bone Joint Surg Br 91:683–690PubMedCrossRef Victor J, Van Doninck D, Labey L, Van Glabbeek F, Parizel P, Bellemans J (2009) A common reference frame for describing rotational alignment of the distal femur. J Bone Joint Surg Br 91:683–690PubMedCrossRef
30.
Zurück zum Zitat Yoshino N, Takai S, Ohtsuki Y, Hirasawa Y (2001) Computed tomography measurement of the surgical and clinical trans epicondylar axis of the distal femur in osteoarthritic knees. J Arthroplasty 16:493–497PubMedCrossRef Yoshino N, Takai S, Ohtsuki Y, Hirasawa Y (2001) Computed tomography measurement of the surgical and clinical trans epicondylar axis of the distal femur in osteoarthritic knees. J Arthroplasty 16:493–497PubMedCrossRef
31.
Zurück zum Zitat Zumstein M, Frauchiger L, Wyss D, Hess R, Ballmer P (2006) Is restricted femoral navigation sufficient for accuracy of total knee arthroplasty. Clin Orthop Relat Res 451:80–86PubMedCrossRef Zumstein M, Frauchiger L, Wyss D, Hess R, Ballmer P (2006) Is restricted femoral navigation sufficient for accuracy of total knee arthroplasty. Clin Orthop Relat Res 451:80–86PubMedCrossRef
Metadaten
Titel
CT measurements prior to computer-assisted total knee arthroplasty do not improve rotational placement of the femoral component
verfasst von
A. de Ladoucette
Publikationsdatum
01.12.2012
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 12/2012
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-012-1909-6

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