Evidence map›Paper›PMID 28194499›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2018

Bone-femoral component interface gap after sagittal mechanical axis alignment is filled with new bone after cementless total knee arthroplasty.

Shinichi Kuriyama, Katsufumi Hyakuna, Satoshi Inoue, Yasutsugu Kawai, Yasuyuki Tamaki, Hiromu Ito, Shuichi Matsuda

Abstract read
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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 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Long-term outcomes were similar between hybrid and cemented TKAs performed on paired knees at a minimum 15 years of follow-up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022
    Article
  6. Article
  7. Underhang of the tibial component increases tibial bone resorption after total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Shinichi KuriyamaDepartment of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan. kuriyama@kuhp.kyoto-u.ac.jp.
Katsufumi HyakunaDepartment of Orthopaedic Surgery, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan.
Satoshi InoueDepartment of Orthopaedic Surgery, Nakae Hospital, Wakayama, Japan.
Yasutsugu KawaiDepartment of Orthopaedic Surgery, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan.
Yasuyuki TamakiDepartment of Orthopaedic Surgery, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan.
Hiromu ItoDepartment of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Shuichi MatsudaDepartment of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study retrospectively evaluated the fate of mismatch between an uncemented femoral component and each femoral cut surface (i.e., wedge-shaped gap) relative to sagittal mechanical alignment in total knee arthroplasty (TKA).

methodsPrimary TKA was performed on 99 consecutive knees. The femoral components were aligned to the sagittal mechanical axis with CT-based navigation. All patients were assessed with postoperative true lateral radiographs. Bone-side surfaces of the uncemented femoral component were divided into five zones: anterior flange, anterior chamfer, posterior chamfer, posterior part, and distal part, which were defined as zones 1 to 5, respectively. Bone filling of wedge-shaped gaps in each zone was evaluated after 1 year.

resultsFemoral anterior notching did not occur. However, wedge-shaped gaps were observed in at least one zone in 23 of 99 knees (23%), most frequently in zone 5 (18%). There were 9 and 7 gaps in zones 1 and 2, respectively. The femoral component showed malpositioning of approximately 3° of flexion in cases with wedge-shaped gaps in zones 2 and/or 5. After one year, 67% (6/9) of zone 1, 100% (7/7) of zone 2, and 94% (17/18) of zone 5 wedge-shaped gaps were filled in with new bone.

conclusionsFemoral alignment relative to sagittal mechanical axis caused wedge-shaped gaps due to unstable anterior bone cutting through hard bone, but the small gaps were not clinically significant and filled in within one year. Sagittal setting of the femoral component should aim for the anatomical axis rather than the mechanical axis. LEVEL OF EVIDENCE: IV.

Indexed as

Knee ProsthesisAgedAged, 80 and overArthroplasty, Replacement, KneeFemaleFemurHumansJoint InstabilityMaleMiddle AgedPostoperative PeriodRange of Motion, ArticularRetrospective StudiesMalpositionMechanical axisSagittal femoral alignmentTotal knee arthroplastyWedge-shaped gap

Identifiers

PMID28194499

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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.