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Erschienen in: Surgical and Radiologic Anatomy 9/2016

12.03.2016 | Anatomic Bases of Medical, Radiological and Surgical Techniques

The linea aspera as a rotational landmark: an anatomical MRI-based study

verfasst von: Gustavo Reple, Arnaud Felden, Antoine Feydy, Philippe Anract, David Biau

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 9/2016

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Abstract

Purpose

The linea aspera can be used as a landmark to assess the rotation of the distal femoral epiphysis when performing an endoprostheses. However, no study has assessed the reliability of this landmark. We therefore asked whether the linea aspera could be used as a rotational landmark for positioning distal femoral knee megaprostheses.

Materials

This is an anatomic MRI-based study of 50 femurs (27 subjects). For each femur, multiple axial sections were obtained from the intercondylar line at the knee joint to the lesser trochanter; each axial section was superposed with that where the posterior condyles were seen and the R angle was measured. The R angle is the angle measured medially where the line passing through the linea aspera and the line tangent to the posterior condyles intersects.

Results

There were considerable differences between and within subjects with a maximum R angle ranging from 100° to 120°. Regression models showed that the R angle was significantly associated with distance from knee joint and subjects.

Conclusion

Surgeons should have the R angle measured before performing a distal femoral reconstruction.
Literatur
1.
Zurück zum Zitat Akaike H (1974) A new look at the statistical model identification. IEEE Trans Autom Control 19(6):716–723CrossRef Akaike H (1974) A new look at the statistical model identification. IEEE Trans Autom Control 19(6):716–723CrossRef
2.
Zurück zum Zitat Barrack RL, Schrader T, Bertot AJ, Wolfe MW, Myers L (2001) Component rotation and anterior knee pain after total knee arthroplasty. Clin Orthop Relat Res 392:46–55CrossRefPubMed Barrack RL, Schrader T, Bertot AJ, Wolfe MW, Myers L (2001) Component rotation and anterior knee pain after total knee arthroplasty. Clin Orthop Relat Res 392:46–55CrossRefPubMed
3.
Zurück zum Zitat Berger RA, Crossett LS, Jacobs JJ, Rubash HE (1998) Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res 356:144–153CrossRefPubMed Berger RA, Crossett LS, Jacobs JJ, Rubash HE (1998) Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res 356:144–153CrossRefPubMed
4.
Zurück zum Zitat Bhattee G, Moonot P, Govindaswamy R, Pope A, Fiddian N, Harvey A (2014) Does malrotation of components correlate with patient dissatisfaction following secondary patellar resurfacing? Knee 21(1):247–251CrossRefPubMed Bhattee G, Moonot P, Govindaswamy R, Pope A, Fiddian N, Harvey A (2014) Does malrotation of components correlate with patient dissatisfaction following secondary patellar resurfacing? Knee 21(1):247–251CrossRefPubMed
5.
Zurück zum Zitat Biau D, Faure F, Katsahian S, Jeanrot C, Tomeno B, Anract P (2006) Survival of total knee replacement with a megaprosthesis after bone tumor resection. J Bone Joint Surg Am 88(6):1285–1293CrossRefPubMed Biau D, Faure F, Katsahian S, Jeanrot C, Tomeno B, Anract P (2006) Survival of total knee replacement with a megaprosthesis after bone tumor resection. J Bone Joint Surg Am 88(6):1285–1293CrossRefPubMed
6.
Zurück zum Zitat Capanna R, Morris HG, Campanacci D, Del Ben M, Campanacci M (1994) Modular uncemented prosthetic reconstruction after resection of tumours of the distal femur. J Bone Joint Surg Br 76(2):178–186PubMed Capanna R, Morris HG, Campanacci D, Del Ben M, Campanacci M (1994) Modular uncemented prosthetic reconstruction after resection of tumours of the distal femur. J Bone Joint Surg Br 76(2):178–186PubMed
7.
Zurück zum Zitat Davidian M, Giltinian DM (1995) Nonlinear models for repeated measurement data. Chapman & Hall/CRC, Boca Raton Davidian M, Giltinian DM (1995) Nonlinear models for repeated measurement data. Chapman & Hall/CRC, Boca Raton
8.
Zurück zum Zitat Davila J, Malkani A, Paiso JM (2001) Supracondylar distal femoral nonunions treated with a megaprosthesis in elderly patients: a report of two cases. J Orthop Trauma 15(8):574–578CrossRefPubMed Davila J, Malkani A, Paiso JM (2001) Supracondylar distal femoral nonunions treated with a megaprosthesis in elderly patients: a report of two cases. J Orthop Trauma 15(8):574–578CrossRefPubMed
9.
Zurück zum Zitat Eckardt JJ, Kabo JM, Kelly CM, Ward WG Sr, Cannon CP (2003) Endoprosthetic reconstructions for bone metastases. Clin Orthop Relat Res 415(Suppl):S254–S262CrossRefPubMed Eckardt JJ, Kabo JM, Kelly CM, Ward WG Sr, Cannon CP (2003) Endoprosthetic reconstructions for bone metastases. Clin Orthop Relat Res 415(Suppl):S254–S262CrossRefPubMed
10.
Zurück zum Zitat Fitzpatrick CK, Baldwin MA, Clary CW, Wright A, Laz PJ, Rullkoetter PJ (2012) Identifying alignment parameters affecting implanted patellofemoral mechanics. J Orthop Res 30(7):1167–1175CrossRefPubMed Fitzpatrick CK, Baldwin MA, Clary CW, Wright A, Laz PJ, Rullkoetter PJ (2012) Identifying alignment parameters affecting implanted patellofemoral mechanics. J Orthop Res 30(7):1167–1175CrossRefPubMed
11.
Zurück zum Zitat Harrison RJ Jr, Thacker MM, Pitcher JD, Temple HT, Scully SP (2006) Distal femur replacement is useful in complex total knee arthroplasty revisions. Clin Orthop Relat Res 446:113–120CrossRefPubMed Harrison RJ Jr, Thacker MM, Pitcher JD, Temple HT, Scully SP (2006) Distal femur replacement is useful in complex total knee arthroplasty revisions. Clin Orthop Relat Res 446:113–120CrossRefPubMed
12.
Zurück zum Zitat Höll S, Schlomberg A, Gosheger G, Dieckmann R, Streitbuerger A, Schulz D, Hardes J (2012) Distal femur and proximal tibia replacement with megaprosthesis in revision knee arthroplasty: a limb-saving procedure. Knee Surg Sports Traumatol Arthrosc 20(12):2513–2518CrossRefPubMed Höll S, Schlomberg A, Gosheger G, Dieckmann R, Streitbuerger A, Schulz D, Hardes J (2012) Distal femur and proximal tibia replacement with megaprosthesis in revision knee arthroplasty: a limb-saving procedure. Knee Surg Sports Traumatol Arthrosc 20(12):2513–2518CrossRefPubMed
13.
Zurück zum Zitat Incavo SJ, Wild JJ, Coughlin KM, Beynnon BD (2007) Early revision for component malrotation in total knee arthroplasty. Clin Orthop Relat Res 458:131–136PubMed Incavo SJ, Wild JJ, Coughlin KM, Beynnon BD (2007) Early revision for component malrotation in total knee arthroplasty. Clin Orthop Relat Res 458:131–136PubMed
14.
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(3):301–305CrossRefPubMed 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(3):301–305CrossRefPubMed
15.
Zurück zum Zitat Liao JG, Lipsitz SR (2002) A type of restricted maximum likelihood estimator for variance components in generalized linear mixed models. Biometrika 89:401–409CrossRef Liao JG, Lipsitz SR (2002) A type of restricted maximum likelihood estimator for variance components in generalized linear mixed models. Biometrika 89:401–409CrossRef
16.
Zurück zum Zitat Malawer MM (2001) Distal femoral resection with endoprosthetic reconstruction. In: Malawer MM, Sugarbaker P (eds) Musculoskeletal cancer surgery treatment of sarcomas and allied diseases. Kluwer Academic Publishers, Berlin, pp 457–481 Malawer MM (2001) Distal femoral resection with endoprosthetic reconstruction. In: Malawer MM, Sugarbaker P (eds) Musculoskeletal cancer surgery treatment of sarcomas and allied diseases. Kluwer Academic Publishers, Berlin, pp 457–481
17.
Zurück zum Zitat Malo M, Vince KG (2003) The unstable patella after total knee arthroplasty: etiology, prevention, and management. J Am Acad Orthop Surg 11(5):364–371CrossRefPubMed Malo M, Vince KG (2003) The unstable patella after total knee arthroplasty: etiology, prevention, and management. J Am Acad Orthop Surg 11(5):364–371CrossRefPubMed
18.
Zurück zum Zitat Park DH, Jaiswal PK, Al-Hakim W, Aston WJ, Pollock RC, Skinner JA, Cannon SR, Briggs TW (2007) The use of massive endoprostheses for the treatment of bone metastases. Sarcoma 2007:62151CrossRefPubMedPubMedCentral Park DH, Jaiswal PK, Al-Hakim W, Aston WJ, Pollock RC, Skinner JA, Cannon SR, Briggs TW (2007) The use of massive endoprostheses for the treatment of bone metastases. Sarcoma 2007:62151CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Pinheiro JC, Bates DM (2000) Mixed-effects models in S and S-Plus. Springer Verlag, New YorkCrossRef Pinheiro JC, Bates DM (2000) Mixed-effects models in S and S-Plus. Springer Verlag, New YorkCrossRef
20.
Zurück zum Zitat R Core Team (2014) R: a language and environment for statistical computing. R foundation for statistical computing. Vienna, Austria. http://www.R-project.org. Accessed 10 Mar 2016 R Core Team (2014) R: a language and environment for statistical computing. R foundation for statistical computing. Vienna, Austria. http://​www.​R-project.​org.​ Accessed 10 Mar 2016
21.
Zurück zum Zitat Sawaguchi N, Majima T, Ishigaki T, Mori N, Terashima T, Minami A (2010) Mobile-bearing total knee arthroplasty improves patellar tracking and patellofemoral contact stress: in vivo measurements in the same patients. J Arthroplasty 25(6):920–925CrossRefPubMed Sawaguchi N, Majima T, Ishigaki T, Mori N, Terashima T, Minami A (2010) Mobile-bearing total knee arthroplasty improves patellar tracking and patellofemoral contact stress: in vivo measurements in the same patients. J Arthroplasty 25(6):920–925CrossRefPubMed
22.
Zurück zum Zitat Schwartz AJ, Kabo JM, Eilber FC, Eilber FR, Eckardt JJ (2010) Cemented distal femoral endoprostheses for musculoskeletal tumor: improved survival of modular versus custom implants. Clin Orthop Relat Res 468(8):2198–2210CrossRefPubMed Schwartz AJ, Kabo JM, Eilber FC, Eilber FR, Eckardt JJ (2010) Cemented distal femoral endoprostheses for musculoskeletal tumor: improved survival of modular versus custom implants. Clin Orthop Relat Res 468(8):2198–2210CrossRefPubMed
23.
Zurück zum Zitat Sharma S, Turcotte RE, Isler MH, Wong C (2006) Cemented rotating hinge endoprosthesis for limb salvage of distal femur tumors. Clin Orthop Relat Res 450:28–32CrossRefPubMed Sharma S, Turcotte RE, Isler MH, Wong C (2006) Cemented rotating hinge endoprosthesis for limb salvage of distal femur tumors. Clin Orthop Relat Res 450:28–32CrossRefPubMed
24.
Zurück zum Zitat Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428CrossRefPubMed Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428CrossRefPubMed
25.
Zurück zum Zitat Sikorski JM (2008) Alignment in total knee replacement. J Bone Joint Surg Br 90(9):1121–1127CrossRefPubMed Sikorski JM (2008) Alignment in total knee replacement. J Bone Joint Surg Br 90(9):1121–1127CrossRefPubMed
26.
Zurück zum Zitat Siston RA, Patel JJ, Goodman SB, Delp SL, Giori NJ (2005) The variability of femoral rotational alignment in total knee arthroplasty. J Bone Joint Surg Am 87(10):2276–2280CrossRefPubMed Siston RA, Patel JJ, Goodman SB, Delp SL, Giori NJ (2005) The variability of femoral rotational alignment in total knee arthroplasty. J Bone Joint Surg Am 87(10):2276–2280CrossRefPubMed
27.
Zurück zum Zitat Springer BD, Sim FH, Hanssen AD, Lewallen DG (2004) The modular segmental kinematic rotating hinge for nonneoplastic limb salvage. Clin Orthop Relat Res 421:181–187CrossRefPubMed Springer BD, Sim FH, Hanssen AD, Lewallen DG (2004) The modular segmental kinematic rotating hinge for nonneoplastic limb salvage. Clin Orthop Relat Res 421:181–187CrossRefPubMed
28.
Zurück zum Zitat Su EP, Su SL, Della Valle AG (2010) Stiffness after TKR: how to avoid repeat surgery. Orthopedics 33(9):658PubMed Su EP, Su SL, Della Valle AG (2010) Stiffness after TKR: how to avoid repeat surgery. Orthopedics 33(9):658PubMed
29.
Zurück zum Zitat Thompson JA, Hast MW, Granger JF, Piazza SJ, Siston RA (2011) Biomechanical effects of total knee arthroplasty component malrotation: a computational simulation. J Orthop Res 29(7):969–975CrossRefPubMed Thompson JA, Hast MW, Granger JF, Piazza SJ, Siston RA (2011) Biomechanical effects of total knee arthroplasty component malrotation: a computational simulation. J Orthop Res 29(7):969–975CrossRefPubMed
30.
Zurück zum Zitat Vaishya R, Singh AP, Hasija R, Singh AP (2011) Treatment of resistant nonunion of supracondylar fractures femur by megaprosthesis. Knee Surg Sports Traumatol Arthrosc 19(7):1137–1140CrossRefPubMed Vaishya R, Singh AP, Hasija R, Singh AP (2011) Treatment of resistant nonunion of supracondylar fractures femur by megaprosthesis. Knee Surg Sports Traumatol Arthrosc 19(7):1137–1140CrossRefPubMed
31.
Zurück zum Zitat Vanbiervliet J, Bellemans J, Verlinden C, Luyckx JP, Labey L, Innocenti B, Vandenneucker H (2011) The influence of malrotation and femoral component material on patellofemoral wear during gait. J Bone Joint Surg Br 93(10):1348–1354CrossRefPubMed Vanbiervliet J, Bellemans J, Verlinden C, Luyckx JP, Labey L, Innocenti B, Vandenneucker H (2011) The influence of malrotation and femoral component material on patellofemoral wear during gait. J Bone Joint Surg Br 93(10):1348–1354CrossRefPubMed
32.
Zurück zum Zitat Verlinden C, Uvin P, Labey L, Luyckx JP, Bellemans J, Vandenneucker H (2010) The influence of malrotation of the femoral component in total knee replacement on the mechanics of patellofemoral contact during gait: an in vitro biomechanical study. J Bone Joint Surg Br 92(5):737–742CrossRefPubMed Verlinden C, Uvin P, Labey L, Luyckx JP, Bellemans J, Vandenneucker H (2010) The influence of malrotation of the femoral component in total knee replacement on the mechanics of patellofemoral contact during gait: an in vitro biomechanical study. J Bone Joint Surg Br 92(5):737–742CrossRefPubMed
33.
Zurück zum Zitat Wakabayashi H, Naito Y, Hasegawa M, Nakamura T, Sudo A (2012) A tumor endoprosthesis is useful in elderly rheumatoid arthritis patient with acute intercondylar fracture of the distal femur. Rheumatol Int 32(5):1411–1413CrossRefPubMed Wakabayashi H, Naito Y, Hasegawa M, Nakamura T, Sudo A (2012) A tumor endoprosthesis is useful in elderly rheumatoid arthritis patient with acute intercondylar fracture of the distal femur. Rheumatol Int 32(5):1411–1413CrossRefPubMed
Metadaten
Titel
The linea aspera as a rotational landmark: an anatomical MRI-based study
verfasst von
Gustavo Reple
Arnaud Felden
Antoine Feydy
Philippe Anract
David Biau
Publikationsdatum
12.03.2016
Verlag
Springer Paris
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 9/2016
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-016-1661-6

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