How to read a postoperative knee replacement radiograph

Al-Hadithy, Nawfal; Papanna, Madhavan C.; Farooq, Sana; Kalairajah, Yegappan

doi:10.1007/s00256-011-1297-x

Cited by 8 publications

(6 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Proximal tibial line (cPTL) is drawn across the flat or concave aspect of the two tibial plateaus' subchondral line in a native knee or the line at the base of the tibial component in TKA. 18 Using the above axes and lines, the following variables are measured: 2,5,19,20 (a) Mechanical axis deviation (MAD) (Figure 1B): is measured as a perpendicular line drawn from Maquet's line (which is the mechanical axis (MA) of the lower limb extending from femoral head center to center of talar dome) 23,24 to the center of the knee; it normally measures 9.7±6.8 mm. 19,20 The relationship between MA and the center of the knee, identified as MAD, is linear; for every 1° of valgus or varus, the MA moves for about 5 mm away from the knee's center.…”

Section: Coronal (C) Plane Evaluation (Ap Radiographs) Patient Positioning and Film Criteriamentioning

confidence: 99%

“…Mechanical axis deviation (MAD) ( Figure 1B ): is measured as a perpendicular line drawn from Maquet’s line (which is the mechanical axis (MA) of the lower limb extending from femoral head center to center of talar dome) 23 , 24 to the center of the knee; it normally measures 9.7±6.8 mm. 19 , 20 The relationship between MA and the center of the knee, identified as MAD, is linear; for every 1° of valgus or varus, the MA moves for about 5 mm away from the knee’s center.…”

Section: Coronal (C) Plane Evaluation (Ap Radiographs)mentioning

confidence: 99%

See 1 more Smart Citation

A Protocol to Systematic Radiographic Assessment of Primary Total Knee Arthroplasty

Khalifa¹,

Mullaji²,

Mostafa³

et al. 2021

ORR

View full text Add to dashboard Cite

Although total knee arthroplasty (TKA) is considered one of the most successful procedures, however, a subset of patients are unsatisfied with the results, even with the introduction of new technologies and implant designs. Radiological assessment of TKA is still considered the most prevalent imaging modality for evaluating the knee joint pre-and postoperatively. Assessment of various angles and indices which could be measured in different radiographic views of the knee provides valuable information about the alignment of the entire limb and the individual prosthetic components, more so in the light of recent nuanced concepts of technique, alignment, and balance. This review article aims to present a comprehensive yet systematic approach to the most useful radiographic parameters for assessing the knee preoperatively and post-TKA by explaining the tools and techniques used for measuring various angles, indices and ratios in the coronal, sagittal and axial planes for diagnosis, preoperative planning, postoperative assessment, and routine follow-up. The protocol we followed in this review entailed first reporting the possible applications and software which could help in measuring these variables, then we mentioned the required series of knee radiographs. For the desired variables, we divided the assessment according to each plane, and in each, we reported the optimum position of the desired radiographic view followed by determining the axis and lines which will later form the desired angles to be measured; finally, we collected all the measurements in a table with the native knee values and the most accepted values after TKA.

show abstract

Section: Coronal (C) Plane Evaluation (Ap Radiographs) Patient Positioning and Film Criteriamentioning

confidence: 99%

Section: Coronal (C) Plane Evaluation (Ap Radiographs)mentioning

confidence: 99%

A Protocol to Systematic Radiographic Assessment of Primary Total Knee Arthroplasty

Khalifa¹,

Mullaji²,

Mostafa³

et al. 2021

ORR

View full text Add to dashboard Cite

show abstract

“…However, it is generally not possible to distinguish between septic and aseptic osteolysis (relating to mechanical loosening/granulomatous disease) based on a single radiograph. Previous radiographs are needed for comparison [11, 13–15]. In cases of aseptic loosening, there is slow and progressive evolution, while in cases of infectious loosening, this loosening occurs rapidly, in a more aggressive manner and with greater bone destruction [16].…”

Section: Clinical Presentations and Diagnosismentioning

confidence: 99%

Periprosthetic Joint Infections

Lima

Oliveira

Carvalho

et al. 2013

Interdisciplinary Perspectives on Infectious Diseases

View full text Add to dashboard Cite

Implantation of joint prostheses is becoming increasingly common, especially for the hip and knee. Infection is considered to be the most devastating of prosthesis-related complications, leading to prolonged hospitalization, repeated surgical intervention, and even definitive loss of the implant. The main risk factors to periprosthetic joint infections (PJIs) are advanced age, malnutrition, obesity, diabetes mellitus, HIV infection at an advanced stage, presence of distant infectious foci, and antecedents of arthroscopy or infection in previous arthroplasty. Joint prostheses can become infected through three different routes: direct implantation, hematogenic infection, and reactivation of latent infection. Gram-positive bacteria predominate in cases of PJI, mainly Staphylococcus aureus and Staphylococcus epidermidis. PJIs present characteristic signs that can be divided into acute and chronic manifestations. The main imaging method used in diagnosing joint prosthesis infections is X-ray. Computed tomography (CT) scan may assist in distinguishing between septic and aseptic loosening. Three-phase bone scintigraphy using technetium has high sensitivity, but low specificity. Positron emission tomography using fluorodeoxyglucose (FDG-PET) presents very divergent results in the literature. Definitive diagnosis of infection should be made by isolating the microorganism through cultures on material obtained from joint fluid puncturing, surgical wound secretions, surgical debridement procedures, or sonication fluid. Success in treating PJI depends on extensive surgical debridement and adequate and effective antibiotic therapy. Treatment in two stages using a spacer is recommended for most chronic infections in arthroplasty cases. Treatment in a single procedure is appropriate in carefully selected cases.

show abstract

“…However, it is generally not possible to distinguish between septic and aseptic osteolysis (relating to mechanical loosening/granulomatous disease) based on a single radiograph. Previous radiographs are needed for comparison [11,[13][14][15]. In cases of aseptic loosening, there is slow and progressive evolution, while in cases of infectious loosening, this loosening occurs rapidly, in a more aggressive manner and with greater bone destruction [16].…”

Section: Clinical Presentations and Diagnosismentioning

confidence: 99%

Periprosthetic Joint Infections

2016

View full text Add to dashboard Cite

How to read a postoperative knee replacement radiograph

Cited by 8 publications

References 54 publications

A Protocol to Systematic Radiographic Assessment of Primary Total Knee Arthroplasty

A Protocol to Systematic Radiographic Assessment of Primary Total Knee Arthroplasty

Periprosthetic Joint Infections

Periprosthetic Joint Infections

Contact Info

Product

Resources

About