ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2018
Does final component alignment correlate with alignment of the bone resection surfaces in cemented total knee arthroplasty?
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- What Are the Optimal Sagittal Alignments in Primary Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.Orthopaedic surgery · 2026Pooled it
- Simultaneous Evaluation of Bone Cut and Implant Placement Accuracy in Robotic-Assisted Total Knee Arthroplasty.Journal of clinical medicine · 2024Article
- Articular surface mounted navigated total knee arthroplasty improves the reliability of component alignment.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo examine, with a navigation, whether the final component alignments correlate with alignment of the bone resection surfaces in cemented total knee arthroplasty (TKA), and to evaluate the factors affecting alignment deviation.
methodsA total of 222 patients (276 knees) who underwent navigation-assisted TKA between September 2012 and January 2014 due to osteoarthritis were retrospectively reviewed. The deviation between the alignment of bone resection surfaces and the final alignment of femoral and tibial components was measured. Factors associated with alignment deviation of greater than 2° (outliers) were evaluated. These included age, sex, body mass index, bone mineral density (T score), preoperative and postoperative mechanical femorotibial angle, preoperative and postoperative flexion contractures, and the difference between medial and lateral gaps in knee extension or flexion.
resultsOutliers consisted of 24 cases (8.6%) on the femoral coronal plane, 4 cases (1.4%) on the tibial coronal plane, and 48 cases (17.4%) on the tibial sagittal plane. In the coronal plane (femur and tibia), the outliers were associated with preoperative [p < 0.001; odds ratio (OR) 0.774; 95% confidence interval (CI) 0.672-0.891] and postoperative (p < 0.001; OR 0.240; 95% CI 0.123-0.468) flexion contractures; a difference of 3 mm or more between the medial and lateral gaps in knee extension (p < 0.041; OR 5.805; 95% CI 1.075-31.343); and a T score of less than -2.5(p < 0.024; OR 5.899; 95% CI 1.258-27.664). In the sagittal plane of the tibia, the outliers were associated with preoperative (p < 0.001; OR 0.886; 95% CI 0.829-0.946) and postoperative (p < 0.031; OR 0.803; 95% CI 0.659-0.980) flexion contractures.
conclusionThere was a deviation between the alignments of the bone resection surfaces and the final alignments of components. With larger preoperative and postoperative flexion contractures in the coronal and sagittal planes, there were more outlier risks. The outliers in the coronal plane were associated with a difference of 3 mm or more between the medial and lateral gaps in knee extension and poor bone quality. Awareness of such alignment deviation and related factors can help diminish the outliers after TKA. LEVEL OF EVIDENCE: IV.
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