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Sagittal magnetic resonance imaging-scan orientation significantly influences accuracy of femoral posterior condylar offset measurement

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

In total knee arthroplasty the femoral posterior condylar offset (PCO) may serve as a potential branch for correct femoral component positioning. The technique of adjusting the sagittal magnetic resonance imaging (MRI)-scan on which it is measured has not been investigated in previous literature, but may be subject to variances due to knee joint positioning or axial localizer scan angulation. The purpose of this study was to investigate the effect of simulated femur rotation on the accuracy of PCO measurement.

Materials and methods

Ten asymptomatic knee joints underwent MRI investigations. A sagittal plane perpendicular to the transepicondylar axis was defined as the true-sagittal plane (tsP). Sagittal images were reformatted in the tsP and angulated by 5° and − 5° in medial and lateral direction. In total each knee received three scans in 0°, 5° and − 5° axial localizer scan angulation. Medial and lateral PCO measurement was performed in each MRI-scan angulation.

Results

Simulated external rotation decreased medial PCO size by 1.7 mm (95% CI 0.5994–3.127) (p = 0.012), and simulated internal rotation increased medial PCO size by 2.1 mm (95% CI 1.142–2.994) (p = 0.001). Lateral PCO size increased by 1.9 mm (95% CI 0.5660–3.412) and decreased by 2.1 mm (95% CI 1.142–2.994) with simulated external and internal rotation, respectively (p = 0.011; p = 0.0007).

Conclusion

This study shows the high sensitivity of medial and lateral PCO measurements to small changes of MRI axial localizer scan angulations simulating minor degrees of internal or external femur rotation. Thus, absolute PCO values should be interpreted with caution if the sagittal image acquisition is not standardized.

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Author notes

  1. Peter Balcarek and Ali Seif Amir Hosseini contributed equally to this work.

Authors and Affiliations

  1. Arcus Sportklinik, Rastatter Str. 17-19, 75179, Pforzheim, Germany

    Peter Balcarek

  2. Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany

    Ali Seif Amir Hosseini & Ulrike Streit

  3. Department of Obstetrics and Gynaecology, Erlangen University Hospital, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany

    Tobias Franz Brodkorb

  4. Department of Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Göttingen, Göttingen, Germany

    Peter Balcarek & Tim Alexander Walde

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  1. Peter Balcarek
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  2. Ali Seif Amir Hosseini
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  3. Ulrike Streit
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  4. Tobias Franz Brodkorb
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  5. Tim Alexander Walde
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Corresponding author

Correspondence to Peter Balcarek.

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Conflict of interest

Peter Balcarek, Ali Seif Amir Hosseini, Ulrike Streit, Tobias F. Brodkorb and Tim A. Walde declare that they have no conflict of interest.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Balcarek, P., Hosseini, A.S.A., Streit, U. et al. Sagittal magnetic resonance imaging-scan orientation significantly influences accuracy of femoral posterior condylar offset measurement. Arch Orthop Trauma Surg 138, 267–272 (2018). https://doi.org/10.1007/s00402-017-2838-0

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  • DOI: https://doi.org/10.1007/s00402-017-2838-0

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