Two-dimensional planning can result in internal rotation of the femoral component in total knee arthroplasty
Purpose The first purpose of this study was to compare the reproducibility of two-dimensional (2D) and three-dimensional (3D) measurements for preoperative planning of the femoral side in total knee arthroplasty (TKA). The second purpose was to evaluate the factors affecting the differences between...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2016-01, Vol.24 (1), p.229-235 |
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| creator | Okamoto, Shigetoshi Mizu-uchi, Hideki Okazaki, Ken Hamai, Satoshi Tashiro, Yasutaka Nakahara, Hiroyuki Iwamoto, Yukihide |
| description | Purpose
The first purpose of this study was to compare the reproducibility of two-dimensional (2D) and three-dimensional (3D) measurements for preoperative planning of the femoral side in total knee arthroplasty (TKA). The second purpose was to evaluate the factors affecting the differences between the 2D and 3D measurements.
Methods
Two-dimensional and 3D measurements for preoperative planning of the femoral side in TKA were evaluated in 75 varus knees with osteoarthritis. The femoral valgus angle, defined as the angle between the mechanical and anatomical axes of the femur, and the clinical rotation angle and surgical rotation angle, defined by the angles between the posterior condylar line and the clinical or surgical transepicondylar axes, respectively, were analysed using 2D (radiographs and axial CT slices) and 3D (3D bone models reconstructed from CT images) measurements.
Results
For all variables, 3D measurements were more reliable and reproducible than 2D measurements. The medians and ranges of the clinical rotation angle and surgical rotation angle were 6.6° (−1.7° to 12.1°) and 2.3° (−2.5° to 8.6°) in 2D, and 7.1° (2.7° to 11.4°) and 3.0° (−2.0° to 7.5°) in 3D. Varus/valgus alteration of the CT scanning direction relative to the mechanical axis affected the difference in clinical rotation angles between 2D and 3D measurements.
Conclusion
Significantly, smaller values of the clinical rotation angle and surgical rotation angle were obtained by 2D compared to 3D measurements, which could result in internal rotation of the femoral component even if the surgeon performs the bone cutting precisely. Regarding clinical relevance, first, this study confirmed the reliability of 3D measurements. Second, it underscored the risk of internal rotation of the femoral component when using 2D measurement, even with precise bone cutting technique. These results will help surgeons avoid malpositioning of the femoral component if 2D measurements are used for preoperative planning in TKA.
Level of evidence
Prospective comparative study, Level Ш. |
| doi_str_mv | 10.1007/s00167-014-3370-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1765975274</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3921849041</sourcerecordid><originalsourceid>FETCH-LOGICAL-c667t-9806bf6d07474d3df5d444bbf1ab235a048c29e7d5c1cd7804856a70e987d7213</originalsourceid><addsrcrecordid>eNqNkV2LFiEYhiWK9m3rB3QSQiedWI-O-oyHsfQFC51sx-KMzu5sM_qmDrH_Pqd3iwiCQPDjubz9uAh5zuE1B8A3BYBrZMAl6zoExh-QA5ddx7CT-JAcwEjBBCh9Rp6UcgvQhtI8JmdCCYMI6kCWq--J-XkNscwpuoUeFxfjHK_p6CLNoWxLpXNsrYa813OqrjaUponWm0CnsKbc1se0HlMM8SddG7TQrzEE6nK9yamllnr3lDya3FLCs_v-nHx5_-7q4iO7_Pzh08XbSzZqjZWZHvQwaQ8oUfrOT8pLKYdh4m4QnXIg-1GYgF6NfPTYt7nSDiGYHj0K3p2TV6fcY07ftlCqXecyhqU9LaStWI5aGVQC5f-gYEQvjGroy7_Q27Ttf7JTShvoQOyB_ESNOZWSw2SPeV5dvrMc7G7NnqzZZs3u1ux-3xf3yduwBv97xy9NDRAnoLRSvA75j6P_mfoDz9CiOA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1756903024</pqid></control><display><type>article</type><title>Two-dimensional planning can result in internal rotation of the femoral component in total knee arthroplasty</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals - AutoHoldings</source><creator>Okamoto, Shigetoshi ; Mizu-uchi, Hideki ; Okazaki, Ken ; Hamai, Satoshi ; Tashiro, Yasutaka ; Nakahara, Hiroyuki ; Iwamoto, Yukihide</creator><creatorcontrib>Okamoto, Shigetoshi ; Mizu-uchi, Hideki ; Okazaki, Ken ; Hamai, Satoshi ; Tashiro, Yasutaka ; Nakahara, Hiroyuki ; Iwamoto, Yukihide</creatorcontrib><description>Purpose
The first purpose of this study was to compare the reproducibility of two-dimensional (2D) and three-dimensional (3D) measurements for preoperative planning of the femoral side in total knee arthroplasty (TKA). The second purpose was to evaluate the factors affecting the differences between the 2D and 3D measurements.
Methods
Two-dimensional and 3D measurements for preoperative planning of the femoral side in TKA were evaluated in 75 varus knees with osteoarthritis. The femoral valgus angle, defined as the angle between the mechanical and anatomical axes of the femur, and the clinical rotation angle and surgical rotation angle, defined by the angles between the posterior condylar line and the clinical or surgical transepicondylar axes, respectively, were analysed using 2D (radiographs and axial CT slices) and 3D (3D bone models reconstructed from CT images) measurements.
Results
For all variables, 3D measurements were more reliable and reproducible than 2D measurements. The medians and ranges of the clinical rotation angle and surgical rotation angle were 6.6° (−1.7° to 12.1°) and 2.3° (−2.5° to 8.6°) in 2D, and 7.1° (2.7° to 11.4°) and 3.0° (−2.0° to 7.5°) in 3D. Varus/valgus alteration of the CT scanning direction relative to the mechanical axis affected the difference in clinical rotation angles between 2D and 3D measurements.
Conclusion
Significantly, smaller values of the clinical rotation angle and surgical rotation angle were obtained by 2D compared to 3D measurements, which could result in internal rotation of the femoral component even if the surgeon performs the bone cutting precisely. Regarding clinical relevance, first, this study confirmed the reliability of 3D measurements. Second, it underscored the risk of internal rotation of the femoral component when using 2D measurement, even with precise bone cutting technique. These results will help surgeons avoid malpositioning of the femoral component if 2D measurements are used for preoperative planning in TKA.
Level of evidence
Prospective comparative study, Level Ш.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-014-3370-1</identifier><identifier>PMID: 25297705</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aged, 80 and over ; Arthritis ; Arthroplasty, Replacement, Knee - adverse effects ; Arthroplasty, Replacement, Knee - methods ; Bone Malalignment - etiology ; Bone Malalignment - prevention & control ; Female ; Femur - surgery ; Humans ; Imaging, Three-Dimensional ; Joint replacement surgery ; Knee ; Male ; Medical imaging ; Medicine ; Medicine & Public Health ; Middle Aged ; Models, Anatomic ; Orthopedics ; Osteoarthritis ; Osteoarthritis, Knee - diagnostic imaging ; Osteoarthritis, Knee - surgery ; Preoperative Care ; Prospective Studies ; Reproducibility of Results ; Rotation ; Surgical techniques ; Tomography, X-Ray Computed</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016-01, Vol.24 (1), p.229-235</ispartof><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2014</rights><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c667t-9806bf6d07474d3df5d444bbf1ab235a048c29e7d5c1cd7804856a70e987d7213</citedby><cites>FETCH-LOGICAL-c667t-9806bf6d07474d3df5d444bbf1ab235a048c29e7d5c1cd7804856a70e987d7213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-014-3370-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-014-3370-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25297705$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Okamoto, Shigetoshi</creatorcontrib><creatorcontrib>Mizu-uchi, Hideki</creatorcontrib><creatorcontrib>Okazaki, Ken</creatorcontrib><creatorcontrib>Hamai, Satoshi</creatorcontrib><creatorcontrib>Tashiro, Yasutaka</creatorcontrib><creatorcontrib>Nakahara, Hiroyuki</creatorcontrib><creatorcontrib>Iwamoto, Yukihide</creatorcontrib><title>Two-dimensional planning can result in internal rotation of the femoral component in total knee arthroplasty</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
The first purpose of this study was to compare the reproducibility of two-dimensional (2D) and three-dimensional (3D) measurements for preoperative planning of the femoral side in total knee arthroplasty (TKA). The second purpose was to evaluate the factors affecting the differences between the 2D and 3D measurements.
Methods
Two-dimensional and 3D measurements for preoperative planning of the femoral side in TKA were evaluated in 75 varus knees with osteoarthritis. The femoral valgus angle, defined as the angle between the mechanical and anatomical axes of the femur, and the clinical rotation angle and surgical rotation angle, defined by the angles between the posterior condylar line and the clinical or surgical transepicondylar axes, respectively, were analysed using 2D (radiographs and axial CT slices) and 3D (3D bone models reconstructed from CT images) measurements.
Results
For all variables, 3D measurements were more reliable and reproducible than 2D measurements. The medians and ranges of the clinical rotation angle and surgical rotation angle were 6.6° (−1.7° to 12.1°) and 2.3° (−2.5° to 8.6°) in 2D, and 7.1° (2.7° to 11.4°) and 3.0° (−2.0° to 7.5°) in 3D. Varus/valgus alteration of the CT scanning direction relative to the mechanical axis affected the difference in clinical rotation angles between 2D and 3D measurements.
Conclusion
Significantly, smaller values of the clinical rotation angle and surgical rotation angle were obtained by 2D compared to 3D measurements, which could result in internal rotation of the femoral component even if the surgeon performs the bone cutting precisely. Regarding clinical relevance, first, this study confirmed the reliability of 3D measurements. Second, it underscored the risk of internal rotation of the femoral component when using 2D measurement, even with precise bone cutting technique. These results will help surgeons avoid malpositioning of the femoral component if 2D measurements are used for preoperative planning in TKA.
Level of evidence
Prospective comparative study, Level Ш.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthritis</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Bone Malalignment - etiology</subject><subject>Bone Malalignment - prevention & control</subject><subject>Female</subject><subject>Femur - surgery</subject><subject>Humans</subject><subject>Imaging, Three-Dimensional</subject><subject>Joint replacement surgery</subject><subject>Knee</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Models, Anatomic</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis, Knee - diagnostic imaging</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Preoperative Care</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>Rotation</subject><subject>Surgical techniques</subject><subject>Tomography, X-Ray Computed</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkV2LFiEYhiWK9m3rB3QSQiedWI-O-oyHsfQFC51sx-KMzu5sM_qmDrH_Pqd3iwiCQPDjubz9uAh5zuE1B8A3BYBrZMAl6zoExh-QA5ddx7CT-JAcwEjBBCh9Rp6UcgvQhtI8JmdCCYMI6kCWq--J-XkNscwpuoUeFxfjHK_p6CLNoWxLpXNsrYa813OqrjaUponWm0CnsKbc1se0HlMM8SddG7TQrzEE6nK9yamllnr3lDya3FLCs_v-nHx5_-7q4iO7_Pzh08XbSzZqjZWZHvQwaQ8oUfrOT8pLKYdh4m4QnXIg-1GYgF6NfPTYt7nSDiGYHj0K3p2TV6fcY07ftlCqXecyhqU9LaStWI5aGVQC5f-gYEQvjGroy7_Q27Ttf7JTShvoQOyB_ESNOZWSw2SPeV5dvrMc7G7NnqzZZs3u1ux-3xf3yduwBv97xy9NDRAnoLRSvA75j6P_mfoDz9CiOA</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Okamoto, Shigetoshi</creator><creator>Mizu-uchi, Hideki</creator><creator>Okazaki, Ken</creator><creator>Hamai, Satoshi</creator><creator>Tashiro, Yasutaka</creator><creator>Nakahara, Hiroyuki</creator><creator>Iwamoto, Yukihide</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20160101</creationdate><title>Two-dimensional planning can result in internal rotation of the femoral component in total knee arthroplasty</title><author>Okamoto, Shigetoshi ; Mizu-uchi, Hideki ; Okazaki, Ken ; Hamai, Satoshi ; Tashiro, Yasutaka ; Nakahara, Hiroyuki ; Iwamoto, Yukihide</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c667t-9806bf6d07474d3df5d444bbf1ab235a048c29e7d5c1cd7804856a70e987d7213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthritis</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Arthroplasty, Replacement, Knee - methods</topic><topic>Bone Malalignment - etiology</topic><topic>Bone Malalignment - prevention & control</topic><topic>Female</topic><topic>Femur - surgery</topic><topic>Humans</topic><topic>Imaging, Three-Dimensional</topic><topic>Joint replacement surgery</topic><topic>Knee</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Models, Anatomic</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Osteoarthritis, Knee - diagnostic imaging</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>Preoperative Care</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>Rotation</topic><topic>Surgical techniques</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Okamoto, Shigetoshi</creatorcontrib><creatorcontrib>Mizu-uchi, Hideki</creatorcontrib><creatorcontrib>Okazaki, Ken</creatorcontrib><creatorcontrib>Hamai, Satoshi</creatorcontrib><creatorcontrib>Tashiro, Yasutaka</creatorcontrib><creatorcontrib>Nakahara, Hiroyuki</creatorcontrib><creatorcontrib>Iwamoto, Yukihide</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Okamoto, Shigetoshi</au><au>Mizu-uchi, Hideki</au><au>Okazaki, Ken</au><au>Hamai, Satoshi</au><au>Tashiro, Yasutaka</au><au>Nakahara, Hiroyuki</au><au>Iwamoto, Yukihide</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Two-dimensional planning can result in internal rotation of the femoral component in total knee arthroplasty</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>24</volume><issue>1</issue><spage>229</spage><epage>235</epage><pages>229-235</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
The first purpose of this study was to compare the reproducibility of two-dimensional (2D) and three-dimensional (3D) measurements for preoperative planning of the femoral side in total knee arthroplasty (TKA). The second purpose was to evaluate the factors affecting the differences between the 2D and 3D measurements.
Methods
Two-dimensional and 3D measurements for preoperative planning of the femoral side in TKA were evaluated in 75 varus knees with osteoarthritis. The femoral valgus angle, defined as the angle between the mechanical and anatomical axes of the femur, and the clinical rotation angle and surgical rotation angle, defined by the angles between the posterior condylar line and the clinical or surgical transepicondylar axes, respectively, were analysed using 2D (radiographs and axial CT slices) and 3D (3D bone models reconstructed from CT images) measurements.
Results
For all variables, 3D measurements were more reliable and reproducible than 2D measurements. The medians and ranges of the clinical rotation angle and surgical rotation angle were 6.6° (−1.7° to 12.1°) and 2.3° (−2.5° to 8.6°) in 2D, and 7.1° (2.7° to 11.4°) and 3.0° (−2.0° to 7.5°) in 3D. Varus/valgus alteration of the CT scanning direction relative to the mechanical axis affected the difference in clinical rotation angles between 2D and 3D measurements.
Conclusion
Significantly, smaller values of the clinical rotation angle and surgical rotation angle were obtained by 2D compared to 3D measurements, which could result in internal rotation of the femoral component even if the surgeon performs the bone cutting precisely. Regarding clinical relevance, first, this study confirmed the reliability of 3D measurements. Second, it underscored the risk of internal rotation of the femoral component when using 2D measurement, even with precise bone cutting technique. These results will help surgeons avoid malpositioning of the femoral component if 2D measurements are used for preoperative planning in TKA.
Level of evidence
Prospective comparative study, Level Ш.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>25297705</pmid><doi>10.1007/s00167-014-3370-1</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016-01, Vol.24 (1), p.229-235 |
| issn | 0942-2056 1433-7347 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals - AutoHoldings |
| subjects | Aged Aged, 80 and over Arthritis Arthroplasty, Replacement, Knee - adverse effects Arthroplasty, Replacement, Knee - methods Bone Malalignment - etiology Bone Malalignment - prevention & control Female Femur - surgery Humans Imaging, Three-Dimensional Joint replacement surgery Knee Male Medical imaging Medicine Medicine & Public Health Middle Aged Models, Anatomic Orthopedics Osteoarthritis Osteoarthritis, Knee - diagnostic imaging Osteoarthritis, Knee - surgery Preoperative Care Prospective Studies Reproducibility of Results Rotation Surgical techniques Tomography, X-Ray Computed |
| title | Two-dimensional planning can result in internal rotation of the femoral component in total knee arthroplasty |
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