ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016
Femur bowing could be a risk factor for implant flexion in conventional total knee arthroplasty and notching in navigated total knee arthroplasty.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Anterior femoral notching ≥ 3 mm is associated with increased risk for supracondylar periprosthetic femoral fracture after total knee arthroplasty: a systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022Pooled it
- Enhancing total knee arthroplasty outcomes: the role of individualized femoral sagittal alignment in robotic-assisted surgery - A randomized controlled trial.Journal of orthopaedic surgery and research · 2024Trial
- Does patient-specific instrumentation increase the risk of notching in the anterior femoral cortex in total knee arthroplasty? A comparative prospective trial.International orthopaedics · 2020Trial
- Anterior Cortical Reference Technique for Sagittal Positioning of Distal Femoral Resection in Kinematic Alignment Total Knee Arthroplasty.Clinics in orthopedic surgery · 2026Article
- The length of lateral radiographs significantly impacts the measurement of the femoral intramedullary axis in patients undergoing total knee arthroplasty.Arthroplasty (London, England) · 2026Article
- Proposing a precision-enhancing method for sagittal plane alignment during total knee arthroplasty.BMC musculoskeletal disorders · 2025Article
- The Optimal Variation Range of Posterior Condylar Offset Associated with Positive Clinical Outcomes of Primary Total Knee Arthroplasty: A Retrospective Analysis.Orthopaedic surgery · 2024Article
- Intraoperative estimation of natural femoral anteversion from proximal femoral osseous orientation during total hip arthroplasty.Journal of orthopaedic surgery and research · 2024Article
- Three-Dimensional Bowing Measurement of Distal Femur at Actual Size and Clinical Implications of Total Knee Arthroplasty.Medicina (Kaunas, Lithuania) · 2024Article
- "Boot Sign" of Anterior Femoral Condylar Resectional Shape during Total Knee Arthroplasty Is More Frequent in Asian Patients.Journal of personalized medicine · 2023Article
- Clinical and Radiological Outcomes of Computer-Assisted versus Conventional Total Knee Arthroplasty at 5-Year Follow-Up: Is There Any Benefit?Journal of personalized medicine · 2023Article
- Higher Pelvic Incidence Was Associated with a Higher Risk of Sagittal Malposition of Femoral Component and Poor Outcomes of Primary Total Knee Arthroplasty: A Retrospective Cohort Analysis.The journal of knee surgery · 2023Article
- Surgical Transepicondylar Axis Is Not a Reliable Reference when there Was Lateral Femoral Bowing.Orthopaedic surgery · 2022Article
- Biomechanical Analysis of the Use of Stems in Revision Total Knee Arthroplasty.Bioengineering (Basel, Switzerland) · 2022Article
- Sagittal femoral bowing contributes to distal femoral valgus angle deviation in malrotated preoperative radiographs.BMC musculoskeletal disorders · 2022Article
- Notching is less, if femoral component sagittal positioning is planned perpendicular to distal femur anterior cortex axis, in navigated TKA.Knee surgery & related research · 2021Article
- Is the femoral component flexion affected by the sagittal femoral shaft bowing in conventional intramedullary guided TKA?Journal of orthopaedic surgery and research · 2021Article
- [Research progress of anterior femoral notching in total knee arthroplasty].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2021Article
- Gender-Based Quantitative Analysis of the Grand Piano Sign in Mechanically Aligned Total Knee Arthroplasty in Asians.Journal of clinical medicine · 2021Article
- Gender difference in bowing of the sagittal femoral morphology measurement using magnetic resonance imaging.Surgical and radiologic anatomy : SRA · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aimed to investigate the relationship between preoperative femoral axes and femoral implant position and to determine how femoral sagittal axes, including femoral anterior bowing, influence the femoral component position in total knee arthroplasty (TKA).
methodsThe relationship between femoral axes (femoral anterior bowing, mechanical axis and the anterior cortical line, intramedullary axis) and implant position was compared in 50 conventional and 50 navigated TKAs. Outliers with more than a 3° margin of error in placement of the femoral component compared with the mechanical axis in the sagittal plane were calculated.
resultsThe femoral component flexion angle was 3.1° in the conventional group and 1.6° in the navigation group (p < 0.001). Anterior femoral bowing correlated positively with the angle between the mechanical axis and implant (r = 0.360, p = 0.010) in the conventional group and negatively with the angle between the anterior cortical line and flange of the femoral component (r = -0.355, p = 0.010) in navigated TKAs. Incidence of outliers was 48 % (24 patients) in the conventional group compared with 10 % (five patients) in the navigated group (p = 0.008).
conclusionsFemoral anterior bowing was an influential factor for implant position and could be a risk factor for both femoral implant flexion in conventional TKAs and notching in navigated TKAs. The results of this study should be considered by surgeons when assessing the risk factors for femoral geometry before performing TKAs, as these results may help them to avoid an overly flexed or extended position of the femoral component, which would affect clinical long-term survival. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.