Radiographic Measures of Knee Alignment in Patients with varus Gonarthrosis

Specogna, Adrian V.; Birmingham, Trevor B.; Hunt, Michael A.; Jones, Ian; Jenkyn, Thomas R.; Fowler, Peter; Giffin, J. Robert

doi:10.1177/0363546506293024

Cited by 134 publications

(66 citation statements)

References 19 publications

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“…They found that when measured at different foot positions (15°external and internal rotation), the mechanical axis deviated by as much as 3.59°. Specogna et al [35] noted divergent measurement results when the lower limbs did not bear weight uniformly, finding a mean varus deviation of 7.1°in a group of patients with uniform loading of the lower limbs compared with 8.7°in patients who stood on both lower limbs but only one bore the body weight. Langenbach et al [36] found that standing radiographs were superior to recumbent images, and Lonner et al [37] stressed a significant influence on results of even slight flexion at the knee.…”

Section: Discussionmentioning

confidence: 99%

Patient-specific computed tomography based instrumentation in total knee arthroplasty: a prospective randomized controlled study

Kotela

2014

International Orthopaedics (SICOT)

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Purpose The aim of this study was to compare radiological results of total knee arthroplasties (TKAs) performed with patient-specific computed tomography (CT)-based instrumentation and conventional technique. The main study hypothesis was that CT-based patient-specific instrumentation (PSI) increases the accuracy of TKA. Methods A prospective, randomized controlled trial was carried out between January and December 2011. A group of 112 patients who met the inclusion and exclusion criteria were enrolled in this study and randomly assigned to an experimental or control group. The experimental group comprised 52 patients operated on with the aid of the Signature™ CT-based implant positioning system. The control group consisted of 60 patients operated on using conventional instrumentation. The radiographic evaluation of implant positioning and overall coronal alignment was performed 12 months after the surgery by using standing anteroposterior radiographs of the entire lower limb and standard lateral radiographs. Results Of the 112 patients initially enrolled for the study, 95 were included in the subsequent analyses. There were no statistically significant differences between groups in respect to coronal and sagittal component positioning and overall coronal alignment, except for frontal tibial component positioning. For this parameter, better results were obtained in the control group, with borderline statistical significance. Conclusions Our study did not reveal superiority of the CTbased PSI system over conventional instrumentation. Further high-quality investigations of patient-specific systems are absolutely indispensable to assess their utility for TKA. In our opinion, the surgeon applying PSI technology is required to have advanced knowledge and considerable experience with the conventional method.

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Section: Discussionmentioning

confidence: 99%

Patient-specific computed tomography based instrumentation in total knee arthroplasty: a prospective randomized controlled study

Kotela

2014

International Orthopaedics (SICOT)

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“…The difference between these two values was used to determine the reduction in serum hemoglobin and thereby estimate the bleeding. Patients who received transfusion of red blood cells or other blood products were excluded.Appearance of the surgical wound one week after the procedure.Functional scales were applied twice a year by examiners blinded to the allocation of groups: the Knee Society Score (KSS), 12 the Western Ontario and McMaster Universities Arthritis Index (WOMAC), 13 and the Kujala Scale 14 ; were applied twice a year by examiners blinded to the allocation of groups.Alignment of the operated limb in the frontal orthostatic panoramic radiography, bipedal, six months after surgery, through the method of anatomical axes of the femur and tibia in the frontal plane 15

Patellar tilt in the axial radiography six months after surgery, according to the technique previously described 16 (Fig.

…”

Section: Methodsmentioning

confidence: 99%

Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty

Filho

Passarelli

Brito

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo compare the clinical and radiological outcomes of conventional medial and lateral approaches for total knee replacement in the valgus osteoarthritic knee.MethodsIn this randomized controlled trial, 21 patients with valgus knee osteoarthritis were randomized to total knee replacement through medial or lateral approach. The primary outcome was radiographic patellar tilt. Secondary outcomes were visual analog scale of pain, postoperative levels of hemoglobin, and clinical aspect of the operative wound.ResultsThere were no differences between the groups regarding other clinical variables. Mean lateral tilt of the patella was 3.1 degrees (SD ± 5.3) in the lateral approach group and 18 degrees (SD ± 10.2) in the medial approach group (p = 0.02). There were no differences regarding the secondary outcomes.ConclusionLateral approach provided better patellar tilt following total knee replacement in valgus osteoarthritic knee.

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“…Femoral and tibial component were cemented. The mechanical axis angles between the tibial axis and an axis connection knee and hip joint centers were determined by radiographs during two legged stance (Specogna et al, 2007;Colebatch et al, 2009). No subject had further joint replacements except K2L, whose contralateral knee had been replaced 6 months previously.…”

Section: Subjectsmentioning

confidence: 99%

Loading of the knee joint during activities of daily living measured in vivo in five subjects

Kutzner

Heinlein

Graichen

et al. 2010

Journal of Biomechanics

636

446

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Radiographic Measures of Knee Alignment in Patients with varus Gonarthrosis

Cited by 134 publications

References 19 publications

Patient-specific computed tomography based instrumentation in total knee arthroplasty: a prospective randomized controlled study

Patient-specific computed tomography based instrumentation in total knee arthroplasty: a prospective randomized controlled study

Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty

Loading of the knee joint during activities of daily living measured in vivo in five subjects

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