The posterior cortical axis as an alternative reference for femoral component placement in total knee arthroplasty
- PDF / 607,075 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 88 Downloads / 178 Views
(2020) 15:603
RESEARCH ARTICLE
Open Access
The posterior cortical axis as an alternative reference for femoral component placement in total knee arthroplasty Ji-Hoon Nam1†, Yong-Gon Koh2†, Kiwon Kang3, Joon-Hee Park4* and Kyoung-Tak Kang1*
Abstract Background: Although several reference axes have been established for determining femoral rotational alignment during total knee arthroplasty (TKA), the most accurate axis is undetermined. This study determines the relationship between the posterior cortical axis (PCA) and the trochlear anterior line (TAL) of the femur in relation to the epicondylar axis. Methods: A total of 341 patients who underwent TKA for osteoarthritis were enrolled. Patients who had undergone previous bony surgery or replacement that might have changed the femoral geometry were excluded. Finally, 336 patients (200 females and 136 males) were included in the study. The angles between the transepicondylar axis (TEA) and TAL and TEA and the femoral PCA (FPCA) were evaluated. We also assessed whether there was any significant differences in variance and gender in these two angles. Student’s t tests were used to determine the significance of coronal alignment and any gender-based differences. The variances between the TAL/TEA and FPCA/TEA angles were compared using F tests. Results: The FPCA was externally rotated by 2.6° ± 3.6°, and the trochlear anterior line was internally rotated by 5.2° ± 5.5°, relative to the TEA. Gender-based differences were observed in the comparisons between anatomical references and TEA. Conclusions: The FPCA is a more conservative landmark than the TAL for intraoperative or postoperative approximation of the TEA. When conventional reference axes, such as the posterior condylar axis and the anteroposterior axis, are inaccurate, surgeons can refer to this alternative reference. These findings demonstrate that the FPCA may be useful for determining the rotational alignment of the femoral component before and during TKA. Keywords: South Korean patients, Trochlear anterior line, Femoral posterior cortical axis, Morphometry, Total knee replacement
* Correspondence: [email protected]; [email protected] † Ji-Hoon Nam and Yong-Gon Koh contributed equally to this work and should be considered co-first authors. 4 Department of Anesthesiology & Pain Medicine, Hallym University College of Medicine and Kangdong Sacred Heart Hospital, 150 Seongan-ro, Gangdong-gu, Seoul 05355, Republic of Korea 1 Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third par
Data Loading...
