ArticleIndian journal of orthopaedics2020
Optimal Flexion for the Femoral Component in TKR: A Study of Angle Between Mechanical Axis and Distal Anatomic Intramedullary Axis Using 3D Reconstructed CT Scans in 407 Osteoarthritic Knees Studied in India.
Article in Indian journal of orthopaedics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 4 citations in OpenAlex.
- 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
- Mid-flexion laxity could be identified with continuous flexion-arc gap assessment in patients with a large preoperative convergence angle.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- 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
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Authors and funding
3 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe femoral component is generally aligned perpendicularly to the distal femoral intramedullary axis with conventional instruments. Various aids like computer navigation, patient-specific instrumentation and robotic surgery use the mechanical axis as the reference for the femoral component alignment. We studied the flexion of the distal femoral intramedullary axis compared to the mechanical axis using an interactive 3D tool in 407 Indian osteoarthritic knees undergoing total knee replacement to better understand optimal flexion alignment. MATERIALS AND
methods407 knees (301-Female, 106-Male) in Indian patients undergoing total knee replacement underwent CT scans. A 3D interactive knee system was used for 3D reconstruction and planning. Distal femoral flexion angle (DFFA) was calculated between the anatomic distal femoral (intramedullary) axis and the mechanical axis. Statistical analysis was performed using ANOVA test and Chi-square test using a data analysis tool pack (Analysis ToolPak by Excel Easy) additionally installed in Microsoft Excel 2010.
resultsThe mean DFFA was found to be 2.54 with a standard deviation of 1.38. The maximum and minimum values noted were 7.5 and 0.5 respectively. There was no correlation found between sex, age, height or weight (
conclusionsWhile taking the distal femur cut with systems other than an intramedullary rod, in Indian osteoarthritic knees, it would be safer to take the distal femoral cut between 2 and 3 degrees of flexion to mechanical axis, as it would ensure that the cut is within 3 degrees from the anatomic axis for 98% patients. Most surgeons routinely using navigation or similar aids take the cut at 0 degrees of flexion to the mechanical axis. This will lead to more than 3 degrees of extension with reference to the intramedullary axis in more than 39% patients. This would result in either an increase in femoral component sizing or an increased risk of notching.
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