Gender differences exist in rotational anatomy of the distal femur in osteoarthritic knees using MRI
- PDF / 844,276 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 52 Downloads / 192 Views
KNEE
Gender differences exist in rotational anatomy of the distal femur in osteoarthritic knees using MRI Yong‑Gon Koh1 · Ji‑Hoon Nam2 · Hyun‑Seok Chung1 · Hyo‑Jeong Kim3 · Hwa‑Yong Lee2 · Kyoung‑Tak Kang2 Received: 10 July 2019 / Accepted: 16 September 2019 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019
Abstract Purpose Optimal rotational alignment of the femoral component is essential for total knee arthroplasty (TKA). The femoral transepicondylar axis (TEA), Whiteside’s line (WSL), and posterior condylar axis (PCA) are various intra-operative references that can be used to determine femoral rotation, and each has advantages and disadvantages. This study aimed to define the rotational anatomy of the distal femur and investigate its relationship with gender in osteoarthritic knees. Methods Magnetic resonance imaging (MRI) was obtained from 1522 patients (1298 females and 224 males) with endstage knee osteoarthritis prior to TKA. MRI was constructed into three-dimensional models. The angles between the TEA and WSL, WSL and PCA, and TEA and PCA were calculated for each patient. In addition, gender differences in femoral rotation were evaluated. Results The PCA was 2.2° ± 1.0° internally rotated relative to the TEA. WSL was 1.2° ± 2.8° externally rotated relative to the TEA. The WSL to TEA relationship exhibited greater variability than the PCA to TEA relationship. PCA was more internally rotated and WSL was more externally rotated relative to TEA in female group than male group. Based on the standard reference rules of 3° external rotation from the PCA that has been conventionally used, 15.7% of patients showed external rotation lower 1° or greater than 5° external rotation from the PCA. In the mean external rotation of the TEA from the PCA (2.2°) from this population; however, the percentage of patients showing ± 2° from their TEA dropped to 5.1% of patients. Conclusion Gender difference and variability exist in distal femoral rotational anatomy. These data can be useful in consideration of femoral anatomy variability and gender difference. The same cutting angle may lead to malrotation of the femoral component. Level of evidence Consecutive patients, level III. Keywords Korean patients · Morphometry · Femoral rotation · Coronal alignment · Total knee replacement · Total knee arthroplasty
Introduction Yong-Gon Koh and Ji-Hoon Nam contributed equally to this work and should be considered co-first authors. * Kyoung‑Tak Kang [email protected] 1
Department of Orthopaedic Surgery, Joint Reconstruction Center, Yonsei Sarang Hospital, 10 Hyoryeong‑ro, Seocho‑gu, Seoul 06698, Republic of Korea
2
Department of Mechanical Engineering, Yonsei University, 50 Yonsei‑ro, Seodaemun‑gu, Seoul 03722, Republic of Korea
3
Department of Sport and Healthy Aging, Korea National Sport University, 1239 Yangjaedaero, Songpa‑gu, Seoul 05541, Republic of Korea
Errors in the femoral rotational alignment in total knee arthroplasty (TKA) can cause problems with tibiofemoral kinematics
Data Loading...
