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Femoral bowing affects varus femoral alignment but not patient satisfaction in mechanically aligned total knee arthroplasty

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

A Correction to this article was published on 29 November 2021

This article has been updated

Abstract

Purpose

This study evaluated whether patients with particular lower limb morphological factors have femoral and tibial component malpositioning during mechanically aligned total knee arthroplasty (TKA) and lower postoperative satisfaction.

Methods

This study included 146 knees in 117 Asian patients undergoing TKA for medial osteoarthritis. Preoperative bony morphological factors such as the angle between the femoral mechanical and anatomical axes (MA-AA angle), angle between the anatomical axes of the proximal and distal femur (lateral bowing femoral angle, LBFA), mechanical lateral distal femoral angle, medial proximal tibial angle, and % anatomical axis of the tibia were evaluated, as well as preoperative and 1-year postoperative 2011 Knee Society scores (KSSs).

Results

MA-AA angle and LBFA were significantly larger in knees with varus femoral component alignment versus neutral alignment. Preoperative MA-AA angle was underestimated in patients with larger MA-AA angle or LBFA, especially by inexperienced surgeons. Tibial morphological factors did not affect tibial component alignment. Changes in 2011 KSSs were similar among groups by lower limb alignment or femoral and tibial component alignment.

Conclusion

Femoral bowing affects varus femoral component alignment by obscuring preoperative planning, but it had little impact on patient satisfaction when mechanical alignment is targeted during TKA.

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Funding

The authors did not receive support from any organizations for the submitted work.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Naoki Umatani, Shinichi Kuriyama, Kohei Nishitani, Shinichiro Nakamura, Hiromu Ito & Shuichi Matsuda

  2. Department of Orthopaedic Surgery, Kansai Electric Power Hospital, Osaka, Japan

    Naoki Umatani

  3. Department of Orthopaedic Surgery, Kurashiki Central Hospital, Okayama, Japan

    Hiromu Ito

Authors
  1. Naoki Umatani
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  2. Shinichi Kuriyama
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  3. Kohei Nishitani
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  4. Shinichiro Nakamura
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  5. Hiromu Ito
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  6. Shuichi Matsuda
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Contributions

N. Umatani acquired and analyzed the data and wrote the manuscript. S. Kuriyama designed the study, acquired and analyzed the data, and wrote the manuscript. K. Nishitani, S. Nakamura, and H Ito acquired the data. S. Matsuda designed the study, acquired the data, and advised on the study. All authors approved the submission.

Corresponding author

Correspondence to Shinichi Kuriyama.

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Conflict of interest

The authors declare they have no financial interests.

Consent to participate

All patients provided informed consent for participation in this study.

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All participants provided informed consent for publication of this study.

Ethical approval

All procedures performed during studies involving human participants were in accordance with the ethical standards of our institution (registration number R1144) and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The original online version of this article was revised: Modifications have been made in the section ‘’Bony morphological factors’’. Full information regarding the corrections made can be found in the erratum/correction for this article.

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Umatani, N., Kuriyama, S., Nishitani, K. et al. Femoral bowing affects varus femoral alignment but not patient satisfaction in mechanically aligned total knee arthroplasty. Eur J Orthop Surg Traumatol 33, 89–96 (2023). https://doi.org/10.1007/s00590-021-03164-0

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  • DOI: https://doi.org/10.1007/s00590-021-03164-0

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