Femoral shaft bowing in the coronal plane has more significant effect on the coronal alignment of TKA than proximal or distal variations of femoral shape

Verfasser / Beitragende:
[Jong-Min Kim, Soo-Heon Hong, Jong-Min Kim, Bum-Sik Lee, Dong-Eun Kim, Kyung-Ah Kim, Seong-Il Bin]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/7(2015-07-01), 1936-1942
Format:
Artikel (online)
ID: 605457115
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024 7 0 |a 10.1007/s00167-014-3006-5  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-3006-5 
245 0 0 |a Femoral shaft bowing in the coronal plane has more significant effect on the coronal alignment of TKA than proximal or distal variations of femoral shape  |h [Elektronische Daten]  |c [Jong-Min Kim, Soo-Heon Hong, Jong-Min Kim, Bum-Sik Lee, Dong-Eun Kim, Kyung-Ah Kim, Seong-Il Bin] 
520 3 |a Purpose: The aim of this study was to determine (1) variations in the shape of the proximal, middle, and distal femur in a series of Korean patients who had undergone total knee arthroplasty (TKA), (2) the preoperative relationship between these three parameters and the distal valgus cutting angle referenced off the femoral intramedullary guide, and (3) whether there was any relationship between femoral bowing and variations in the shape of the proximal or distal femur in the coronal plane. Methods: The preoperative long-standing anteroposterior radiographs of 316 consecutive osteoarthritis patients who underwent primary TKA from 2009 to 2011 were examined. The femoral neck shaft angle, the femoral shaft bowing angle, and the mechanical lateral distal femoral angle were measured to assess the shape of the proximal, middle, and distal femur, respectively. The valgus cutting angle of the femur was defined as the angle between the distal anatomical and mechanical axes of the femur. Results: The study population showed large variations in femoral shape. The mean femoral intramedullary guide angle was 6.5°±1.3° (range: 4°-13°). The femoral shaft bowing angle was the factor that showed the strongest correlation with this angle (P<0.001). The mechanical lateral distal femoral angle showed only a weak correlation (P=0.001), and the femoral neck shaft angle showed no correlation (n.s.). The femoral shaft bowing angle showed a weak correlation with the mechanical lateral distal femoral angle (P=0.001), but was not significantly correlated with the femoral neck shaft angle (n.s.). Apparent femoral bowing (>3° of lateral or medial bowing) was found in 42 (13.3%) of cases (37 cases of lateral bowing and five of medial bowing). Cases with lateral apparent femoral bowing >3° had a distal cutting angle of 8.6°±2.2° relative to the femoral intramedullary guide. Conclusion: The femoral intramedullary guide angle was mainly influenced by femoral shaft bowing among femoral deformities in the coronal plane. Therefore, to increase the accuracy of distal femoral cut during TKA, it is necessary to confirm femoral deformities and to measure the femoral intramedullary guide angle preoperatively from coronal radiographs covering the whole femur. Level of evidence: IV. 
540 |a Springer-Verlag Berlin Heidelberg, 2014 
690 7 |a Femoral bowing in the coronal plane  |2 nationallicence 
690 7 |a Alignment  |2 nationallicence 
690 7 |a Total knee arthroplasty  |2 nationallicence 
690 7 |a Angle of femoral intramedullary guide  |2 nationallicence 
700 1 |a Kim  |D Jong-Min  |u Department of Orthopaedic Surgery, Kosin Gospel Hospital, College of Medicine, Kosin University, 34, Amnam-dong, Seo-gu, 602-702, Busan, South Korea  |4 aut 
700 1 |a Hong  |D Soo-Heon  |u Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, 388-1, Pungnap-2-dong, Songpa-gu, 138-736, Seoul, South Korea  |4 aut 
700 1 |a Kim  |D Jong-Min  |u Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, 388-1, Pungnap-2-dong, Songpa-gu, 138-736, Seoul, South Korea  |4 aut 
700 1 |a Lee  |D Bum-Sik  |u Department of Orthopaedic Surgery, Incheon St. Mary's Hospital, College of Medicine, Catholic University, Bupyeong 6-dong, Bupyeong-gu, 403-720, Inchon, South Korea  |4 aut 
700 1 |a Kim  |D Dong-Eun  |u Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, 388-1, Pungnap-2-dong, Songpa-gu, 138-736, Seoul, South Korea  |4 aut 
700 1 |a Kim  |D Kyung-Ah  |u Department of Biomedical Engineering, College of Medicine, Chungbuk National University, Gaesin-dong, Heungdeok-gu, 361-763, Cheongju-si, Chungcheongbuk-do, South Korea  |4 aut 
700 1 |a Bin  |D Seong-Il  |u Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, 388-1, Pungnap-2-dong, Songpa-gu, 138-736, Seoul, South Korea  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/7(2015-07-01), 1936-1942  |x 0942-2056  |q 23:7<1936  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-3006-5  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-3006-5  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kim  |D Jong-Min  |u Department of Orthopaedic Surgery, Kosin Gospel Hospital, College of Medicine, Kosin University, 34, Amnam-dong, Seo-gu, 602-702, Busan, South Korea  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Hong  |D Soo-Heon  |u Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, 388-1, Pungnap-2-dong, Songpa-gu, 138-736, Seoul, South Korea  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kim  |D Jong-Min  |u Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, 388-1, Pungnap-2-dong, Songpa-gu, 138-736, Seoul, South Korea  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Lee  |D Bum-Sik  |u Department of Orthopaedic Surgery, Incheon St. Mary's Hospital, College of Medicine, Catholic University, Bupyeong 6-dong, Bupyeong-gu, 403-720, Inchon, South Korea  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kim  |D Dong-Eun  |u Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, 388-1, Pungnap-2-dong, Songpa-gu, 138-736, Seoul, South Korea  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kim  |D Kyung-Ah  |u Department of Biomedical Engineering, College of Medicine, Chungbuk National University, Gaesin-dong, Heungdeok-gu, 361-763, Cheongju-si, Chungcheongbuk-do, South Korea  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Bin  |D Seong-Il  |u Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, 388-1, Pungnap-2-dong, Songpa-gu, 138-736, Seoul, South Korea  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/7(2015-07-01), 1936-1942  |x 0942-2056  |q 23:7<1936  |1 2015  |2 23  |o 167