ArticleJournal of clinical medicine2021
Gender-Based Quantitative Analysis of the Grand Piano Sign in Mechanically Aligned Total Knee Arthroplasty in Asians.
Article in Journal of clinical medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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
3 citing papers in PubMed, 3 citations in OpenAlex.
- The grand piano ratio: an adjunctive intraoperative screening tool for detecting excessive femoral component external rotation in total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2026Article
- Review
- Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty : finite element analysis indicating anatomical design prevents stress-shielding.Bone & joint research · 2022Article
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
In mechanically aligned (MA) total knee arthroplasty (TKA), the grand piano sign helps surgeons to further ensure the proper external rotation of the femoral component. The goal of this study was to determine the sex-related differences in the shape of the anterior resection surface using 3D magnetic resonance imaging (MRI) models. MRI scans were performed on 267 consecutive patients (202 women and 65 men) with osteoarthritis who underwent TKA in order to reconstruct a 3D model. Virtual anterior condylar resection was performed based on the surgical transepicondylar axis (sTEA), Whiteside's line (WSL), and flexion-extension axis (FEA). On the anterior resection surface, both lateral length (LatL) and medial length (MedL) were measured, and the ratio between the two (MedL/LatL) was calculated. The mediolateral width of the distal femur (ML) and anterior resection surface (M'L') were measured, and the ratio between the M'L' and ML (M'L'/ML) was calculated. Both the lateral deviation (LD) and the ratio between LD and ML (LD/ML) were also determined. Morphological classification of the anterior resection surface was conducted based on the presence of a definite medial peak. When based on the sTEA or WSL, the MedL/LatL of female subjects was significantly greater than that of male subjects (
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Registered trials
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