Do long leg supine CT scanograms correlate with weight-bearing full-length radiographs to measure lower limb coronal alignment?

Gbejuade, Herbert; White, Peter B.; Hassaballa, M; Porteous, A; Robinson, Jonathan; Murray, James R. D.

doi:10.1016/j.knee.2013.05.009

Cited by 46 publications

(54 citation statements)

References 16 publications

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“…TKA preoperative analysis of key lower extremity variables such as varus/valgus and femur torsion is vitally important for enhanced surgical planning [3, 4]. This study aimed to validate a device which could potentially eradicate the use of invasive methods, such as full-length X-rays, with the use of an ultrasound-integrated motion capture system.…”

Section: Discussionmentioning

confidence: 99%

“…Alongside the fact that there is a predicted 700% rise in total knee arthroplasty (TKA) by 2030 in the USA alone means that such revision rates (including the revision rate which increases beyond the 10 year mark) will equate to a very large number of people and significant cost [2]. Preoperative, lower extremity kinematic evaluations for total hip and knee arthroplasties are therefore considered crucial for successful surgery and patient satisfaction [3, 4]. Accurate determination of kinematic parameters such as the varus/valgus is a key factor for correct surgical planning [5].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Reliability of an Integrated Ultrasound and Stereophotogrammetric System for Lower Limb Anatomical Characterisation

Greatrex

Montefiori

Grupp

et al. 2017

Applied Bionics and Biomechanics

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Background Lower extremity analysis for preoperative total knee and hip arthroplasty routines can increase surgery success rate and hence reduce associated costs. Current tools are limited by being invasive, limited to supine analysis, or too expensive. This study aimed to propose and validate a device, OrthoPilot®, based on the combined use of a stereophotogrammetric and ultrasound system which can in vivo and noninvasively measure varus/valgus, flexion/extension, femur and tibia torsion, and femur and tibia lengths. Methods A phantom was measured by four operators to determine the resolution of the system. Interoperator variability was measured on three operators who measured the above six variables on both legs of three subjects in standing and supine positions. Intraoperator variability was assessed on data from three repeats from 9 subjects (18 legs). Results All 6 variables were reliably detected on a phantom, with a resolution of 1 mm and 0.5°. Inter- and intraoperator consistency was observed for varus/valgus, flexion/extension, and length measurements on the healthy subjects in standing and supine positions (all ICC > 0.93). For torsion measurements, there was a considerable variation. Conclusion The proposed system, when used on healthy subjects, allowed reliable measurements of key parameters for preoperative procedures in both supine and standing positions. Accuracy testing and further validation on patient populations will be the next step toward its clinical adoption.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reliability of an Integrated Ultrasound and Stereophotogrammetric System for Lower Limb Anatomical Characterisation

Greatrex

Montefiori

Grupp

et al. 2017

Applied Bionics and Biomechanics

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show abstract

“…Gbejuade HO et al stated that in the malaligned limb, weight-bearing full length X-ray still remains a vital imaging modality [27]. When compared to weight-bearing full length X ray, supine Computerized Tomographic scanogram should be used with caution in view of the under-detection of malalignment [27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

“…When compared to weight-bearing full length X ray, supine Computerized Tomographic scanogram should be used with caution in view of the under-detection of malalignment [27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Role of full length weight bearing radiograph in assessing the Alignment in Total Knee Arthroplasty

Subramanian¹,

Sengodan²

2016

IOSR

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“…radiographs of the entire leg were aquired under full weight-bearing. The leg was in neutral rotation with the patella facing straight forward, the fibular head covered by the tibia for one third and correct projection of the trochanter minor and ankle [17][18][19][20]. Geometrical angles and axes were measured using the software mediCad.…”

Section: Radiological Analysismentioning

confidence: 99%

Accuracy of tibial positioning in the frontal plane: a prospective study comparing conventional and innovative techniques in total knee arthroplasty

Zahn

Graef

Conrad

et al. 2020

Arch Orthop Trauma Surg

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Background Coronal alignment of the tibial component determines functional outcome and survival in total knee arthroplasty (TKA). Innovative techniques for tibial instrumentation have been developed to improve accuracy and reduce the rate of outliers. Methods In a prospective study, 300 patients were allocated to four different groups using a randomization process (two innovative and two conventional) techniques of tibial instrumentation (conventional: extramedullary, intramedullary; innovative: navigation and patient-specific instrumentation (PSI); n = 75 for each group). The aims were to reconstruct the medial proximal tibial angle (MPTA) to 90° and the mechanical tibio-femoral axis (mTFA) to 0°. Both angles were evaluated and compared between all groups three months after the surgery. Patients who presented with a postoperative mTFA > 3° were classified as outliers. Results The navigation and intramedullary technique both demonstrated that they were significantly more precise in reconstructing a neutral mTFA and MPTA compared to the other two techniques. The odd's ratio (OR) for producing outliers was highest for the PSI method (PSI OR = 5.5, p < 0.05; extramedullary positioning OR = 3.7, p > 0.05; intramedullary positioning OR = 1.7, p > 0.05; navigation OR = 0.04, p < 0.05). We could only observe significant differences between pre-and postoperative MPTA in the navigation and intramedullary group. The MPTA showed a significant negative correlation with the mTFA in all groups preoperatively and in the extramedullary, intramedullary and PSI postoperatively. Conclusion The navigation and intramedullary instrumentation provided the precise positioning of the tibial component. Outliers were most common within the PSI and extramedullary technique. Optimal alignment is dependent on the technique of tibial instrumentation and tibial component positioning determines the accuracy in TKA since mTFA correlated with MPTA pre-and postoperatively.

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Do long leg supine CT scanograms correlate with weight-bearing full-length radiographs to measure lower limb coronal alignment?

Cited by 46 publications

References 16 publications

Reliability of an Integrated Ultrasound and Stereophotogrammetric System for Lower Limb Anatomical Characterisation

Reliability of an Integrated Ultrasound and Stereophotogrammetric System for Lower Limb Anatomical Characterisation

Role of full length weight bearing radiograph in assessing the Alignment in Total Knee Arthroplasty

Accuracy of tibial positioning in the frontal plane: a prospective study comparing conventional and innovative techniques in total knee arthroplasty

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