Femoral Mechanical–Anatomical Angle Measurements in Total Knee Arthroplasty: Analog versus Digital

J Knee SurgDOI: 10.1055/s-0034-1384214Preoperative planning in total knee arthroplasty with intramedullary guiding systems requires the measurement of the femoral mechanical–anatomical angle (FMAA) for optimal alignment correction. The main goal of this study was to assess the agreement between two digital FMAA measurements and the analog FMAA measurement. Overall 41 anteroposterior weight-bearing hip-to-ankle radiographs of patients undergoing total knee arthroplasty were used for the measurements of the FMAA. The analog method (gold standard, GS) was compared with two new digital methods (DIG1 and DIG2) using intraclass correlation (ICC) and Bland–Altman plots, measured by three blinded raters. The ICC for measurements of the FMAA comparing the GS and DIG1 was 0.48 (95% confidence interval [CI] 0.20–0.68), and 0.53 (95% CI 0.26–0.73) for comparing GS and DIG2. The ICC between raters for DIG1 was 0.79 (95% CI 0.68–0.88) and 0.88 (95% CI 0.80–0.93) for DIG2. Bland–Altman plots showed a mean difference between the GS and DIG1 of −0.44 degrees, with 95% limits of agreement from 1.21 to −2.09 degrees. The mean difference between the GS and DIG2 was −0.68 degrees with 95% limits of agreement from 0.99 to −2.35 degrees. It was concluded that the digital FMAA measurement is less reliable than analog measurement in total knee arthroplasty.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Artic...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research

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AbstractPurposeLimb length discrepancy (LLD) has been related to inferior outcomes after total hip arthroplasty (THA), but few studies have dealt with the LLD in primary total knee arthroplasty (TKA). The aims of the study were to examine the incidence of LLD after TKA and how it can influence in the outcomes scores.MethodsWe analysed preoperative, postoperative and changes in LLD in 460 patients who underwent a unilateral primary TKA. The measurements were done on digital full leg radiographs preoperatively and 6  months after surgery. The hip–knee–ankle (HKA) angle was also measured on these radiographs....
Source: European Journal of Orthopaedic Surgery and Traumatology - Category: Orthopaedics Source Type: research
We describe a technique of autograft har vest from the ipsilateral calcaneus. We present a retrospective case series of clinical and radiographic outcomes of distraction arthrodesis with bicortical calcaneal autograft in patients with failed procedures of the first MTPJ.
Source: Journal of Foot and Ankle Surgery - Category: Orthopaedics Authors: Source Type: research
We describe, in this article, the hinged joint distraction technique. A total of 50 patients with posttraumatic ankle osteoarthritis with a mean age of 40.0±8.5 years were included in a prospective randomized study: 25 patients in ankle debridement alone group and 25 patients in debridement and hinged ankle distraction group. The mean follow-up was 46±12 months (range: 36 to 78 mo). The clinical and radiographic outcomes were evaluated at the 6-month and 3-year follow-up using the Visual Analog Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, SF-36 quality of life score,...
Source: Techniques in Foot and Ankle Surgery - Category: Orthopaedics Tags: Special Focus Source Type: research
AbstractPurposeThe purpose of this study was to analyze the long-term clinical and radiological outcomes of patients who underwent closing-wedge High Tibial Osteotomy (HTO) for the treatment of medial compartment osteoarthritis and to evaluate the conversion rate to knee arthroplasty.MethodsA retrospective, non-randomized, monocentric study was performed in our Institution considering 166 patients between 1989 and 2012. The final population was composed by 82 patients (94 knees), median age at time of operation was 53 (range 45 –73) years. All patients were evaluated clinically (HSS Score, Tegner Scale, VAS and Crosb...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
In conclusion, although the incidence of heterotopic ossification after TAA is considerable, there is insufficient literature to suggest that heterotopic ossification after TAA impacts range of motion or functional outcome.
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
ConclusionVarus deformity in the proximal part of the tibia, immediate postoperative varus alignment, and varus position of the femoral and tibial components may lead to varus progression in limb alignment in the long term, even 10  years after TKA; the surgeon should, therefore, weigh the risks of leaving a varus alignment during surgery. Moreover, if the preoperative TPTPS angle is high, the alignment may become varus after TKA, even in patients who have acquired neutral alignment.Level of evidenceIV.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
CONCLUSION: In varus knees, the proximal tibia has a medial shift of the TAS that may influence the value of the HKA angle. PMID: 32067563 [PubMed - in process]
Source: Journal of Orthopaedic Surgery - Category: Orthopaedics Authors: Tags: J Orthop Surg (Hong Kong) Source Type: research
J Knee Surg DOI: 10.1055/s-0039-3402044Since a hindfoot alignment is not included in the conventional mechanical axis (hip–ankle [HA] line), a mechanical axis including the calcaneus (hip–calcaneus [HC] line) has recently attracted attention as an alternative weight-bearing line. However, there are few reports on unicompartmental knee arthroplasty (UKA) regarding the HC line. Therefore, this study aimed to compare postoperative alignments after UKA between the HA line and the HC line. Postoperatively, HC radiographs were taken in 88 consecutive patients who underwent medial UKA. The hip–knee–ankle (...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
Publication date: Available online 26 December 2019Source: The Journal of Foot and Ankle SurgeryAuthor(s): Jonathan Lee, Eric So, Daniel B. LoganAbstractThe purpose of this study is to report the outcome of the conversion of a first metatarsophalangeal (MTP) joint arthrodesis to an interpositional arthroplasty with an acellular dermal matrix for a chronic nonhealing first ray wound. To our knowledge, this is the first case report converting a first ray arthrodesis to an interpositional arthroplasty to heal a chronic ulceration. A 78-year-old female developed a chronic neuropathic ulceration under the first metatarsal head ...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
Abstract It is controversial whether supramalleolar osteotomy is suitable for Takakura Stage 3B osteoarthritis or not. The aim of this study was to evaluate the outcomes of supramalleolar osteotomy in patients with Takakura 3B osteoarthritis. From February 2008 to August 2013, supramalleolar osteotomy was performed in 21 patients matching the inclusion criteria. The mean patient age at operation was 53.7±5.8 years (range: 39 to 61 years). The mean duration of follow-up was 87.7±19.5 months (range: 61 to 125 months). The radiologic evaluation included the tibial articular surface (TAS) angle, tibial l...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
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