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Pre-operative radiological measurement of femoral rotation for prosthetic positioning in total knee arthroplasty

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Abstract

Purpose

This study outlines the benefits of the seated view radiograph of the knee in evaluation of the pre-operative individual distal femoral torsion (DFT) and for the follow-up of the post-operative rotational positioning of the femoral component in total knee arthroplasty.

Methods

Study on 20 patients who underwent total knee arthroplasty and the correlation between the DFT measured before surgery with this radiology view, the intra-operative external rotation (ER) necessary for the parallel positioning of the femoral component with the transepicondylar axis (TEA) and the post-operative femoral rotational alignment of the prosthesis on the same view.

Results

In 90 % of cases the values of internal DFT were between −10 and −80, while the mean value of the internal rotation (IR) was −4.450. The mean value of the ER applied to the posterior bone resection was 4.250 (00–70), showing a statistically significant correlation between the pre-operative measurement and the intra-operative one of the posterior condylar angle (PCA) (r = 0.890, p = 0.000). Residual internal femoral malrotation has been identified in four cases, its mean value being 0.40. In three patients the pre-operative value of the PCA was higher than the intra-operative one and an internal malrotation of the post-operative femoral component was observed.

Conclusions

The results are encouraging for the further use of this pre-operative view with the premises of increasing the accuracy of prosthetic positioning and reducing the mechanical complications.

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Authors and Affiliations

  1. Department of Orthopedics and Trauma, Clinical Rehabilitation Hospital, Iasi, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania

    Liliana Savin, Paul Botez, Dan Mihailescu & Carmen Grierosu

  2. Department of Orthopedics and Trauma, St Pantelimon Clinical Hospital Bucharest, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania

    Vlad Predescu

Authors
  1. Liliana Savin
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  2. Paul Botez
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  3. Dan Mihailescu
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  4. Vlad Predescu
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  5. Carmen Grierosu
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Corresponding author

Correspondence to Paul Botez.

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Conflict of interest

No funds were received in support of this study. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Savin, L., Botez, P., Mihailescu, D. et al. Pre-operative radiological measurement of femoral rotation for prosthetic positioning in total knee arthroplasty. International Orthopaedics (SICOT) 40, 1855–1860 (2016). https://doi.org/10.1007/s00264-015-3110-2

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  • DOI: https://doi.org/10.1007/s00264-015-3110-2

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