Trial reportInternational orthopaedics2016
Partially loaded plain radiographic measurement to evaluate rotational alignment in total knee arthroplasty.
Trial report in International orthopaedics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 8 citations in OpenAlex.
- Femur rotational alignment in total knee arthroplasty: Delphi consensus statements from European knee society (EKS).Archives of orthopaedic and trauma surgery · 2025Article
- Third-generation posterior-stabilised cemented system for total knee arthroplasty: Survivorship and outcomes after 20-year follow-up.Journal of experimental orthopaedics · 2024Article
- Three-dimensional color map: a novel tool to locate the surgical transepicondylar axis.Annals of translational medicine · 2020Article
- Methods of intra- and post-operative determination of the position of the tibial component during total knee replacement.International orthopaedics · 2020Review
- Three dimensional gait analysis in patients with symptomatic component mal-rotation after total knee arthroplasty.International orthopaedics · 2019Article
- Clinical and radiological analysis of a personalized total knee arthroplasty system design.International orthopaedics · 2019Article
- Presence of rotational errors in long leg radiographs after total knee arthroplasty and impact on measured lower limb and component alignment.International orthopaedics · 2017Article
- Long-term follow-up of a non-randomised prospective cohort of one hundred and ninety two total knee arthroplasties using the NexGen implant.International orthopaedics · 2017Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRotational alignment of prosthetic components after total knee arthroplasty (TKA) is predominantly monitored with computer tomography (CT), for example by relating the anatomical transepicondylar axis (a-TEA) of the native femur to the posterior bicondylar axis of the prosthetic component (PBCA). The purpose of the present study was to portray a reliable, novel plain radiographic method that likewise enables the evaluation of rotational positioning of prosthetic components in TKA. Furthermore, it was intended to evaluate the prosthetic femoro-tibial functional behavior under loaded conditions.
methodsModified plain axial radiographs under partial weight bearing (20 kg) were performed in 63 patients (63 knees) after TKA. On the obtained radiographs, all established, relevant anatomic, and prosthetic axis and angles reflecting the rotational position of the femoral (i.e., a-TEA/PBCA angle) and tibial component were detected twice by two independent examiners with an interval of one month. Additionally, in 14 cases with anterior knee pain after surgery, radiographic results were compared to obtained computer tomography images; intraclass coefficients (ICC's) for intra- and inter-rater reliability were calculated.
resultsAll pre-assigned axis and angles could be identified doubtlessly by both examiners in all investigated knees. For all measurements, ICC's for intra-rater and inter-rater reliability ranged from 0.75 to 0.96. The comparison of the radiographic measurements with corresponding CT results (n = 14) revealed no significant differences (p > 0.05). Rotational alignment of the tibial tray in relation to the native tibial bone was not measurable due to display overlaying. Femoro-tibial behaviour of the prosthetic components under partial loading showed a high variability.
conclusionWe were able to establish a new reliable radiographic technique that is able to show the most established and relevant anatomic landmarks and prosthetic axis after TKA to assess the rotational alignment of the prosthetic components in TKA in relation to the distal femur. The evaluation of the femoro-tibal behaviour instead shows a high variability and so far does not allow valid explanatory conclusions.
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