Rotational Alignment of the Distal Femur in the Anatolian Population - Suitability of Standard Guidelines for Knee Arthroplasty

Oğuzhan Çimen; Ruhat Ünlü

Makale detayları

Rotational Alignment of the Distal Femur in the Anatolian Population - Suitability of Standard Guidelines for Knee Arthroplasty

Yazarlar:

Oğuzhan Çimen | Ruhat Ünlü

Yayıncı:

Kirikkale University

Ana Başlıklar:

Sağlık Hizmetleri ve Sistemleri (Diğer)

Dergi:

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi Vol.26 Issue 3, pp.363-367

Belge Tipi:

Makale

Yayın Tarihi:

12/2024

Belge Dili:

Türkçe

Document ID (Org No.):

2001334962

pISSN:

2148-9645

Anahtar kelimeler:

Özet:

 Objective: The rotation of the femoral component in total knee arthroplasty TKA is crucial for knee kinematics and functional outcomes. This study aimed to evaluate the posterior condylar angle PCAn and the condylar twisting angle CTA in an Anatolian population. Additionally, we aimed to assess the suitability of standard posterior condylar axis PCA reference incision blocks used in TKA for this population. Material and Methods: In this retrospective, observational, analytical study, we examined knee computed tomography CT images of 130 patients aged 18 to 60 years. The PCAn was measured as the angle between the axis extending from the medial epicondylar sulcus to the lateral epicondyle cTEA and PCA. The CTA was defined as the angle between the axis extending from the medial epicondyle to the lateral epicondyle aTEA and PCA. Results: The mean PCAn was measured as 3.521.45 1.8 external rotation to 8 internal rotation, and the CTA was measured as 6.581.47 range 2-9.9 internal rotation. One hundred and five knees 80.8 were within individual anatomic limits for PCAn, while there were 25 outliers 19.2, 9 in the external rotation ER group and 16 in the internal rotation IR group. The angle measurements on CT had excellent intra- and inter-observer reliability. Conclusion: This study shows that in 80.8 of the Anatolian population, the posterior condylar reference is an acceptable reference for femoral component rotation in TKA surgery, but in 19.2, it is not an appropriate reference because it will cause malrotation. Orthopedic surgeons should be ready to modify the surgical technique when necessary, considering other reference points to properly align the femoral implant along the TEA while performing TKA with posterior reference equipment.

 Objective: The rotation of the femoral component in total knee arthroplasty TKA is crucial for knee kinematics and functional outcomes. This study aimed to evaluate the posterior condylar angle PCAn and the condylar twisting angle CTA in an Anatolian population. Additionally, we aimed to assess the suitability of standard posterior condylar axis PCA reference incision blocks used in TKA for this population. Material and Methods: In this retrospective, observational, analytical study, we examined knee computed tomography CT images of 130 patients aged 18 to 60 years. The PCAn was measured as the angle between the axis extending from the medial epicondylar sulcus to the lateral epicondyle cTEA and PCA. The CTA was defined as the angle between the axis extending from the medial epicondyle to the lateral epicondyle aTEA and PCA. Results: The mean PCAn was measured as 3.521.45 1.8 external rotation to 8 internal rotation, and the CTA was measured as 6.581.47 range 2-9.9 internal rotation. One hundred and five knees 80.8 were within individual anatomic limits for PCAn, while there were 25 outliers 19.2, 9 in the external rotation ER group and 16 in the internal rotation IR group. The angle measurements on CT had excellent intra- and inter-observer reliability. Conclusion: This study shows that in 80.8 of the Anatolian population, the posterior condylar reference is an acceptable reference for femoral component rotation in TKA surgery, but in 19.2, it is not an appropriate reference because it will cause malrotation. Orthopedic surgeons should be ready to modify the surgical technique when necessary, considering other reference points to properly align the femoral implant along the TEA while performing TKA with posterior reference equipment.

 Objective: The rotation of the femoral component in total knee arthroplasty TKA is crucial for knee kinematics and functional outcomes. This study aimed to evaluate the posterior condylar angle PCAn and the condylar twisting angle CTA in an Anatolian population. Additionally, we aimed to assess the suitability of standard posterior condylar axis PCA reference incision blocks used in TKA for this population. Material and Methods: In this retrospective, observational, analytical study, we examined knee computed tomography CT images of 130 patients aged 18 to 60 years. The PCAn was measured as the angle between the axis extending from the medial epicondylar sulcus to the lateral epicondyle cTEA and PCA. The CTA was defined as the angle between the axis extending from the medial epicondyle to the lateral epicondyle aTEA and PCA. Results: The mean PCAn was measured as 3.521.45 1.8 external rotation to 8 internal rotation, and the CTA was measured as 6.581.47 range 2-9.9 internal rotation. One hundred and five knees 80.8 were within individual anatomic limits for PCAn, while there were 25 outliers 19.2, 9 in the external rotation ER group and 16 in the internal rotation IR group. The angle measurements on CT had excellent intra- and inter-observer reliability. Conclusion: This study shows that in 80.8 of the Anatolian population, the posterior condylar reference is an acceptable reference for femoral component rotation in TKA surgery, but in 19.2, it is not an appropriate reference because it will cause malrotation. Orthopedic surgeons should be ready to modify the surgical technique when necessary, considering other reference points to properly align the femoral implant along the TEA while performing TKA with posterior reference equipment.

 Amaç: Total diz artroplastisi TDA ameliyatında femoral komponentin rotasyonu diz kinematiği ve fonksiyonel sonuçlar açısından oldukça önemlidir. Bu çalışmanın amacı, Anadolu popülasyonunda posterior kondiler açı PKAç ve Kondiler bükülme açısını KBA değerlendirmektir. Ayrıca, TDAda kullanılan standart posterior kondiler aks PKA referans insizyon bloklarının Anadolu popülasyonu için uygunluğunun değerlendirilmesidir. Gereç ve Yöntemler: Bu retrospektif, gözlemsel, analitik çalışmada 18-60 yaş arası 130 hastanın diz bilgisayarlı tomografi BT görüntüleri üzerinde ölçümler yapıldı. PKAç medial epikondiler sulkustan lateral epikondile uzanan aks cTEA ile PKA arasındaki açı, KBA ise medial epikondilden lateral epikondile uzanan aks aTEA ile PKA arasındaki açı olarak ölçüldü. Bulgular: Ortalama PKAç 3.521.45 1.8 dış rotasyon ile 8 iç rotasyon aralığı, KBA 6.58  1.47 2-9.9 iç rotasyon aralığı olarak ölçüldü. Yüz beş diz 80.8 PKAç açısından bireysel anatomik sınırlar içindeyken, 9u eksternal rotasyonda ER ve 16sı internal rotasyonda İR grubunda olmak üzere 25 aykırı değer 19.2 vardı. BTdeki açı ölçümleri, hem gözlemci içi hem de gözlemciler arası güvenilirliği mükemmeldi. Sonuç: Bu çalışma, Anadolu popülasyonun 80.8inde posterior kondiler referansın TDA ameliyatında femoral komponent rotasyonu için kabul edilebilir bir referans olduğu, fakat 19.2sinde ise malrotasyona neden olacağı için uygun bir referans olmadığını göstermektedir. Ortopedik cerrahlar, TDAyı posterior referans ekipmanı ile uygularken femoral implantı TEA boyunca düzgün bir şekilde hizalamak için diğer referans noktaları dikkate alarak cerrahi tekniği gerektiğinde değiştirmeye hazır olmalıdır.

Makale detayları

Rotational Alignment of the Distal Femur in the Anatolian Population - Suitability of Standard Guidelines for Knee Arthroplasty

Yazarlar:

Oğuzhan Çimen | Ruhat Ünlü

Yayıncı:

Kirikkale University

Ana Başlıklar:

Sağlık Hizmetleri ve Sistemleri (Diğer)

Dergi:

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi Vol.26 Issue 3, pp.363-367

Belge Tipi:

Makale

Yayın Tarihi:

12/2024

Belge Dili:

Türkçe

Document ID (Org No.):

2001334962

pISSN:

2148-9645

Posterior condylar axis

trans epicondylar axis

condylar twist angle

total knee arthroplasty

computerized tomographyPosterior kondiler aks

trans epikondiler aks

kondiler bükülme açısı

total diz artroplastisi

bilgisayarlı tomografi

Sayı

Makale detayları

Yazarlar: Oğuzhan Çimen | Ruhat Ünlü

Yayıncı: Kirikkale University

Ana Başlıklar: Sağlık Hizmetleri ve Sistemleri (Diğer)

Dergi: Kırıkkale Üniversitesi Tıp Fakültesi Dergisi Vol.26 Issue 3, pp.363-367

Belge Tipi: Makale

Yayın Tarihi: 12/2024

Belge Dili: Türkçe

Document ID (Org No.): 2001334962

pISSN: 2148-9645

Sayı

Yazarlar:

Oğuzhan Çimen | Ruhat Ünlü

Yayıncı:

Kirikkale University

Ana Başlıklar:

Sağlık Hizmetleri ve Sistemleri (Diğer)

Dergi:

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi Vol.26 Issue 3, pp.363-367

Belge Tipi:

Makale

Yayın Tarihi:

12/2024

Belge Dili:

Türkçe

Document ID (Org No.):

2001334962

pISSN:

2148-9645