2D versus 3D templating in total knee arthroplasty

Ettinger, Max; Claaßen, Leif; Paes, Peter; Calließ, Tilman

doi:10.1016/j.knee.2015.08.014

Cited by 41 publications

(38 citation statements)

References 14 publications

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“…18 Recently, Ettinger et al found very good results of preoperative planning of implant size using three-dimensional (3D) magnetic resonance imaging (MRI) reconstructions. 22 In 3D templating, a 100% accurate prediction was found. These images can also be helpful for the intraoperative plan.…”

Section: Discussionmentioning

confidence: 98%

“…However, a selective population was included in this study. 22 Computed tomography is also examined for preoperative planning, in which 3D reconstructions were superior over 2D conventional radiographs to determine preoperative TKA implant size. 23 The width of the foot can change after adulthood secondary to hallux valgus or other pathology or deformity of the foot.…”

Section: Discussionmentioning

confidence: 99%

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The Correlation of Shoe Size and Component Size of Primary Total Knee Arthroplasty

et al. 2019

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Preoperative planning is an important phase of total joint arthroplasty. Current template programs and methods only provide moderate accuracy for implant size prediction. Recently, a relationship between shoe size and implant size was found. We hypothesized that shoe size shows a high percentage of agreement for implant size of both femoral and tibial component size in primary total knee arthroplasty (TKA). The aim of this study was to investigate the correlation and agreement between shoe size and TKA implant size. We performed a retrospective cohort study. Of all patients, who underwent primary TKA between September 2013 and March 2016, shoe size and knee implant sizes were collected. Cross-tabulation was used to determine the correlation and agreement between shoe size and implant size. A total of 489 patients (498 TKA) were included. The correlation coefficient for femoral and tibial component with shoe size was 0.751 and 0.759, respectively. When a deviation of ± 1 component size was allowed, shoe size gave at least 94% agreement score for femoral component and at least 86% agreement score in tibial component. We conclude that both femoral and tibial component size have a good correlation with shoe size. Therefore, shoe size may be used as a valuable predictor in preoperative implant size planning for primary TKA. The level of evidence for this study was Level IV.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

The Correlation of Shoe Size and Component Size of Primary Total Knee Arthroplasty

et al. 2019

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“…Tokyo, Japan) [6,13]. The area of each footprint, and the length between the most distal and the most posterior point of the lateral femoral condyle and the edge of each footprint were measured.…”

Section: Methodsmentioning

confidence: 99%

The evaluation of the distance between the popliteus tendon and the lateral collateral ligament footprint and the implant in Total Knee Arthroplasty using a 3-dimensional template.

Takubo

Ryu

Iriuchishima³

et al. 2020

Preprint

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Background The popliteus tendon (PT) or lateral collateral ligament (LCL) stabilizes the postero-lateral aspects of the knees. When surgeons perform total knee arthroplasty (TKA), PT and LCL iatrogenic injuries are a risk because the femoral attachments are relatively close to the femoral bone resection area. The purpose of this study was to evaluate the distance between the PT or LCL footprint and the TKA implant using a 3D template system and to evaluate any significant differences according to the implant model.Methods Eighteen non-paired formalin fixed cadaveric lower limbs were used (average age: 80.3). Whole length lower limbs were resected from the pelvis. All the surrounding soft tissue except the PT, knee ligaments and meniscus were removed from the limb. Careful dissection of the PT and LCL was performed, and the femoral footprints were detected. Each footprint periphery was marked with a 1.5 mm K-wire. Computed tomography (CT) scanning of the whole lower limb was then performed. The CT data was analyzed with a 3D template system. This simulation models for TKA were the Journey II BCS and the Persona PS. The area of each footprint, and the length between the most distal and posterior point of the lateral femoral condyle and the edge of each footprint were measured. Matching the implant model to the CT image of the femur, the shortest length between each footprint and the bone resection area were calculated.Results PT and LCL footprint were detected in all knees. The area of the PT and LCL footprints was 38.7±17.7mm2 and 58.0±24.6mm2, respectively. The length between the most distal and posterior point of the lateral femoral condyle and the edge of the PT footprint was 10.3±2.4mm and 14.2±2.8mm, respectively. The length between most distal and most posterior point of the lateral femoral condyle and the edge of the LCL footprint was 16.3±2.3mm and 15.5±3.3mm, respectively. Under TKA simulation, the shortest length between the PT footprint and the femoral bone resection area for the Journey II BCS and the Persona PS was 4.3±2.5mm and 3.2±2.9mm, respectively. The shortest length between the LCL footprint and the femoral bone resection area for the Journey II BCS and the Persona PS was 7.2±2.3mm and 5.6±2.1mm, respectively. The PT attachment was damaged by the bone resection of the Journey II BCS and the Persona PS TKA in 3 and 9 knees, respectively.Conclusion The PT and LCL femoral attachments existed close to the femoral bone resection area of the TKA. To prevent postero-lateral instability in TKA, careful attention is needed to avoid damage to the PT and LCL during surgical procedures.

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“…Preoperative planning in total knee arthroplasty (TKA) is increasingly relevant to reduce intraoperative errors related to implant sizing and bony resections, and provides the opportunity to prepare the surgical instrumentation and access to the implant system [1]. The global "gold standard" in clinical preoperative planning in TKA is based on the two-dimensional (2D) geometrical analysis of anterior-posterior (AP) standing long-leg radiographs [2].…”

Section: Introductionmentioning

confidence: 99%

Evaluation and validation of 2D biomechanical models of the knee for radiograph-based preoperative planning in total knee arthroplasty

et al. 2020

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Thorough preoperative planning in total knee arthroplasty is essential to reduce implant failure by proper implant sizing and alignment. The "gold standard" in conventional preoperative planning is based on anterior-posterior long-leg radiographs. However, the coronal component alignment is still an open discussion in literature, since studies have reported contradictory outcomes on survivorship, indicating that optimal individual alignment goals still need to be defined. Two-dimensional biomechanical models of the knee have the potential to predict joint forces and, therefore, objectify therapy planning. Previously published two-dimensional biomechanical models were evaluated and validated for the first time in this study by comparison of model predictions to corresponding in vivo measurements obtained from telemetric implants for a one-and two-leg stance. Model input parameters were acquired from weight-bearing anterior-posterior long-leg radiographs and statistical assumptions for patient-specific model adaptation. The overall time from initialization to load prediction was in the range of 7-8 minutes per patient for all models. However, no model could accurately predict the correct trend of knee joint forces over patients. Two dimensional biomechanical models of the knee have the potential to improve preoperative planning in total knee arthroplasty by providing additional individual biomechanical information to the surgeon. Although integration into the clinical workflow might be performed with acceptable costs, the models' accuracy is insufficient for the moment. Future work is needed for model optimization and more sophisticated modelling approaches.

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2D versus 3D templating in total knee arthroplasty

Cited by 41 publications

References 14 publications

The Correlation of Shoe Size and Component Size of Primary Total Knee Arthroplasty

The Correlation of Shoe Size and Component Size of Primary Total Knee Arthroplasty

The evaluation of the distance between the popliteus tendon and the lateral collateral ligament footprint and the implant in Total Knee Arthroplasty using a 3-dimensional template.

Evaluation and validation of 2D biomechanical models of the knee for radiograph-based preoperative planning in total knee arthroplasty

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