Abstract
We compared lower limb coronal alignment measurements obtained pre- and postoperatively with long-leg radiographs and computer navigation in patients undergoing primary total knee replacement (TKR). A series of 185 patients had their pre- and postimplant radiological and computer-navigation system measurements of coronal alignment compared using the Bland-Altman method. The study included 81 men and 104 women with a mean age of 68.5 years (32 to 87) and a mean body mass index of 31.7 kg/m2 (19 to 49). Pre-implant Bland-Altman limits of agreement were -9.4° to 8.6° with a repeatability coefficient of 9.0°. The Bland-Altman plot showed a tendency for the radiological measurement to indicate a higher level of pre-operative deformity than the corresponding navigation measurement. Post-implant limits of agreement were -5.0° to 5.4° with a repeatability coefficient of 5.2°. The tendency for valgus knees to have greater deformity on the radiograph was still seen, but was weaker for varus knees. The alignment seen or measured intra-operatively during TKR is not necessarily the same as the deformity seen on a standing long-leg radiograph either pre- or post-operatively. Further investigation into the effect of weight-bearing and surgical exposure of the joint on the mechanical femorotibial angle is required to enable the most appropriate intra-operative alignment to be selected.
| Language | English |
|---|---|
| Pages | 1234-1240 |
| Number of pages | 7 |
| Journal | Journal of Bone and Joint Surgery, British Volume |
| Volume | 94 B |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 1 Sep 2012 |
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Keywords
- adult
- article
- body mass
- female
- human
- infant
- leg
- leg malformation
- major clinical study
- male
- priority journal
- total knee replacement
- valgus deformity
- valgus knee
- varus deformity
- varus knee
- weight bearing
- X ray film
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A comparison of radiological and computer navigation measurements of lower limb coronal alignment before and after total knee replacement. / Willcox, N. M J; Clarke, J. V.; Smith, B. R K; Deakin, A. H.; Deep, K.
In: Journal of Bone and Joint Surgery, British Volume , Vol. 94 B, No. 9, 01.09.2012, p. 1234-1240.Research output: Contribution to journal › Article
TY - JOUR
T1 - A comparison of radiological and computer navigation measurements of lower limb coronal alignment before and after total knee replacement
AU - Willcox, N. M J
AU - Clarke, J. V.
AU - Smith, B. R K
AU - Deakin, A. H.
AU - Deep, K.
PY - 2012/9/1
Y1 - 2012/9/1
N2 - We compared lower limb coronal alignment measurements obtained pre- and postoperatively with long-leg radiographs and computer navigation in patients undergoing primary total knee replacement (TKR). A series of 185 patients had their pre- and postimplant radiological and computer-navigation system measurements of coronal alignment compared using the Bland-Altman method. The study included 81 men and 104 women with a mean age of 68.5 years (32 to 87) and a mean body mass index of 31.7 kg/m2 (19 to 49). Pre-implant Bland-Altman limits of agreement were -9.4° to 8.6° with a repeatability coefficient of 9.0°. The Bland-Altman plot showed a tendency for the radiological measurement to indicate a higher level of pre-operative deformity than the corresponding navigation measurement. Post-implant limits of agreement were -5.0° to 5.4° with a repeatability coefficient of 5.2°. The tendency for valgus knees to have greater deformity on the radiograph was still seen, but was weaker for varus knees. The alignment seen or measured intra-operatively during TKR is not necessarily the same as the deformity seen on a standing long-leg radiograph either pre- or post-operatively. Further investigation into the effect of weight-bearing and surgical exposure of the joint on the mechanical femorotibial angle is required to enable the most appropriate intra-operative alignment to be selected.
AB - We compared lower limb coronal alignment measurements obtained pre- and postoperatively with long-leg radiographs and computer navigation in patients undergoing primary total knee replacement (TKR). A series of 185 patients had their pre- and postimplant radiological and computer-navigation system measurements of coronal alignment compared using the Bland-Altman method. The study included 81 men and 104 women with a mean age of 68.5 years (32 to 87) and a mean body mass index of 31.7 kg/m2 (19 to 49). Pre-implant Bland-Altman limits of agreement were -9.4° to 8.6° with a repeatability coefficient of 9.0°. The Bland-Altman plot showed a tendency for the radiological measurement to indicate a higher level of pre-operative deformity than the corresponding navigation measurement. Post-implant limits of agreement were -5.0° to 5.4° with a repeatability coefficient of 5.2°. The tendency for valgus knees to have greater deformity on the radiograph was still seen, but was weaker for varus knees. The alignment seen or measured intra-operatively during TKR is not necessarily the same as the deformity seen on a standing long-leg radiograph either pre- or post-operatively. Further investigation into the effect of weight-bearing and surgical exposure of the joint on the mechanical femorotibial angle is required to enable the most appropriate intra-operative alignment to be selected.
KW - adult
KW - article
KW - body mass
KW - female
KW - human
KW - infant
KW - leg
KW - leg malformation
KW - major clinical study
KW - male
KW - priority journal
KW - total knee replacement
KW - valgus deformity
KW - valgus knee
KW - varus deformity
KW - varus knee
KW - weight bearing
KW - X ray film
UR - http://www.scopus.com/inward/record.url?scp=84866510785&partnerID=8YFLogxK
U2 - 10.1302/0301-620X.94B9.28250
DO - 10.1302/0301-620X.94B9.28250
M3 - Article
VL - 94 B
SP - 1234
EP - 1240
JO - Journal of Bone and Joint Surgery, British Volume
T2 - Journal of Bone and Joint Surgery, British Volume
JF - Journal of Bone and Joint Surgery, British Volume
SN - 0301-620X
IS - 9
ER -