ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2015
Femoral shaft bowing in the coronal plane has more significant effect on the coronal alignment of TKA than proximal or distal variations of femoral shape.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
43 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Extramedullary versus intramedullary femoral alignment technique in total knee arthroplasty: a meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2017Pooled it
- Alignment accuracy and functional outcomes between hand-held navigation and conventional instruments in TKA: a randomized controlled trial.BMC musculoskeletal disorders · 2022Trial
- Accuracy of empirical distal femoral valgus cut angle of 4° to 6° in total knee arthroplasty: a randomized controlled trial.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022Trial
- Posterior femoral condylar morphology following mechanical vs. kinematic alignment using a medial-pivot implant designed for mechanical alignment: A CT-based comparative study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Age-related varus progression of femoral bowing and its related factors in the Iwaki cohort study.Journal of experimental orthopaedics · 2025Article
- Mechanical Axis Deviation Angle Versus Hip-Knee-Ankle Angle in Total Knee Arthroplasty: Correlation and Reliability.Indian journal of orthopaedics · 2025Article
- No single safe zone exists for the valgus cut angle to reproduce neutral mechanical alignment in the presence of femoral bowing in total knee arthroplasty.Musculoskeletal surgery · 2025Observational
- Simulation of osteotomy in total knee arthroplasty with femoral extra-articular deformity assisted by artificial intelligence: a study based on three-dimensional models.Journal of orthopaedic surgery and research · 2024Article
- Article
- Learning curve of robot-assisted total knee arthroplasty and its effects on implant position in asian patients: a prospective study.BMC musculoskeletal disorders · 2023Article
- Risk Factors Associated with Intraoperative Iatrogenic Fracture in Patients Undergoing Intramedullary Nailing for Atypical Femoral Fractures with Marked Anterior and Lateral Bowing.Medicina (Kaunas, Lithuania) · 2023Article
- Proximal external femoral torsion increases lateral femoral shaft bowing: a study based on 3D CT reconstruction models.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Coronal plane femoral bowing in Far East Asians: implications for the strategy of distal femoral resection in total knee arthroplasty.Journal of orthopaedic surgery and research · 2022Article
- Correlation of short knee and full-length X-rays in evaluating coronal plane alignment in total knee arthroplasty.Journal of orthopaedic surgery and research · 2022Article
- Sagittal femoral bowing contributes to distal femoral valgus angle deviation in malrotated preoperative radiographs.BMC musculoskeletal disorders · 2022Article
- The accuracy of an extramedullary femoral cutting system in total knee arthroplasty in patients with severe coronal femoral bowing: a radiographic study.Journal of orthopaedic surgery and research · 2022Article
- Femoral Valgus Correction Angle for the Intramedullary Alignment Rod Is Strongly Associated with Femoral Lateral Bowing in Japanese Patients with Varus Knee Osteoarthritis Undergoing Total Knee Arthroplasty.Advances in orthopedics · 2022Article
- Relationship between degenerative scoliosis and lower extremity mechanical parameters based on EOS imaging system.American journal of translational research · 2022Article
- Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation Study.Frontiers in bioengineering and biotechnology · 2022Article
- Is the femoral component flexion affected by the sagittal femoral shaft bowing in conventional intramedullary guided TKA?Journal of orthopaedic surgery and research · 2021Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study was to determine (1) variations in the shape of the proximal, middle, and distal femur in a series of Korean patients who had undergone total knee arthroplasty (TKA), (2) the preoperative relationship between these three parameters and the distal valgus cutting angle referenced off the femoral intramedullary guide, and (3) whether there was any relationship between femoral bowing and variations in the shape of the proximal or distal femur in the coronal plane.
methodsThe preoperative long-standing anteroposterior radiographs of 316 consecutive osteoarthritis patients who underwent primary TKA from 2009 to 2011 were examined. The femoral neck shaft angle, the femoral shaft bowing angle, and the mechanical lateral distal femoral angle were measured to assess the shape of the proximal, middle, and distal femur, respectively. The valgus cutting angle of the femur was defined as the angle between the distal anatomical and mechanical axes of the femur.
resultsThe study population showed large variations in femoral shape. The mean femoral intramedullary guide angle was 6.5° ± 1.3° (range: 4°-13°). The femoral shaft bowing angle was the factor that showed the strongest correlation with this angle (P < 0.001). The mechanical lateral distal femoral angle showed only a weak correlation (P = 0.001), and the femoral neck shaft angle showed no correlation (n.s.). The femoral shaft bowing angle showed a weak correlation with the mechanical lateral distal femoral angle (P = 0.001), but was not significantly correlated with the femoral neck shaft angle (n.s.). Apparent femoral bowing (>3° of lateral or medial bowing) was found in 42 (13.3 %) of cases (37 cases of lateral bowing and five of medial bowing). Cases with lateral apparent femoral bowing >3° had a distal cutting angle of 8.6° ± 2.2° relative to the femoral intramedullary guide.
conclusionThe femoral intramedullary guide angle was mainly influenced by femoral shaft bowing among femoral deformities in the coronal plane. Therefore, to increase the accuracy of distal femoral cut during TKA, it is necessary to confirm femoral deformities and to measure the femoral intramedullary guide angle preoperatively from coronal radiographs covering the whole femur. LEVEL OF EVIDENCE: IV.
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