Evidence map›Paper›PMID 35142899›Full record

ArticleEuropean radiology2022

CT measures of femoral and tibial version and rotational position of femoral and tibial components of knee replacements: limitations in reliability and suitability for routine clinical practice.

Andoni P Toms, Tamam Rifai, Celia Whitehouse, Iain McNamara

Open access · hybridAbstract read
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Article in European radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 29% of its field
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

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Andoni P TomsDepartment of Radiology, Norfolk & Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK. andoni.toms@uea.ac.uk.
Tamam RifaiDepartment of Radiology, Norfolk & Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
Celia WhitehouseDepartment of Trauma & Orthopaedics, Norfolk & Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
Iain McNamaraNorwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK.
Norfolk and Norwich University Hospital · GBUniversity of East Anglia · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesRotational malalignment of knee replacements as measured on CT is understood to be associated with poor outcomes. The aim of this study is to measure the inter-rater and intra-rater reliability of measures of femoral and tibial version in the native arthritic knee and postoperative TKR component position using CT.

methodsEighty patients underwent CT of the knee before and after total knee replacement. Preoperative femoral and tibial version and component rotation were independently measured by two musculoskeletal radiologists.

resultsMean differences between and within raters were small (< 1.6°). Maximum 95% limits of agreement for inter-rater and intra-rater comparisons were 8.1° and 7.6° for preoperative femoral version, 9.0° and 7.9° for postoperative femoral rotation, 26.0° and 20.5° for preoperative tibial version, and 24.9° and 23.6° for postoperative tibial rotation respectively. Postoperative ICCs varied from 0.68 to 0.81 (lower 95% CI:0.55-0.72) for both intra- and inter-rater comparisons. Preoperative ICCs were lower: 0.55-0.75 (lower 95% CI:0.40-0.65).

conclusionThe lower 95% confidence level for ICC of version and rotational measurements using the Berger protocol of TKRs on CT are all less than 0.73 and that the normal range of differences between observers is up to 9° for the femoral component and 26° for the tibial component. This suggests that CT measurements derived from the Berger protocol may not be consistent enough for clinical practice. KEY POINTS: • CT is commonly used to measure the rotational profile of knee replacements in symptomatic patients using the Berger protocol. • The limits of agreement for both femoral and tibial component rotation are wide even for experienced observers. • CT measurements of the rotation of knee arthroplasty are not reliable enough for routine clinical use.

Indexed as

Arthroplasty, Replacement, KneeFemurHumansKnee JointReproducibility of ResultsTibiaTomography, X-Ray ComputedArthroplastyCTKneeReproducibility of resultsRotation

Identifiers

PMID35142899
PMCPMC9122870
OpenAlexW4211036495

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