caa a22 4500 605460876 CHVBK 20210128100240.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00167-014-3137-8 doi (NATIONALLICENCE)springer-10.1007/s00167-014-3137-8 The sulcus line of the trochlear groove is more accurate than Whiteside's Line in determining femoral component rotation [Elektronische Daten] [Simon Talbot, Pandelis Dimitriou, Ross Radic, Rachel Zordan, John Bartlett] Purpose: The sulcus line (SL) is a three-dimensional curve produced from multiple points along the trochlear groove. Whiteside's Line, also known as the anteroposterior axis (APA), is derived from single anterior and posterior points. The purposes of the two studies presented in this paper are to (1) assess the results from the clinical use of the SL in a large clinical series, (2) measure the SL and the APA on three-dimensional CT reconstructions, (3) demonstrate the effect of parallax error on the use of the APA and (4) determine the accuracy of an axis derived by combining the SL and the posterior condylar axis (PCA). Methods: In the first study, we assessed the SL using a large, single surgeon series of consecutive patients undergoing primary total knee arthroplasties. The post-operative CT scans of patients (n=200) were examined to determine the final rotational alignment of the femoral component. In the second study, measurements were taken in a series of 3DCT reconstructions of osteoarthritic knees (n=44). Results: The mean position of the femoral component in the clinical series was 0.6° externally rotated to the surgical epicondylar axis, with a standard deviation of 2.9° (ranges from −7.2° to 6.7°). On the 3DCT reconstructions, the APA (88.2°±4.2°) had significantly higher variance than the SL (90.3°±2.7°) (F=5.82 and p=0.017). An axis derived by averaging the SL and the PCA+3° produced a significant decrease in both the number of outliers (p=0.03 vs. PCA and p=0.007 vs. SL) and the variance (F=6.15 and p=0.015 vs. SL). The coronal alignment of the SL varied widely relative to the mechanical axis (0.4°±3.8°) and the distal condylar surface (2.6°±4.3°). Conclusions: The multiple points used to determine the SL confer anatomical and geometrical advantages, and therefore, it should be considered a separate rotational landmark to the APA. These findings may explain the high degree of variability in the measurement of the APA which is documented in the literature. Combining a geometrically correct SL and the PCA is likely to further improve accuracy. Springer-Verlag Berlin Heidelberg, 2014 Knee nationallicence Arthroplasty nationallicence Rotation nationallicence Femoral component rotation nationallicence Total knee arthroplasty nationallicence Whiteside's Line nationallicence Sulcus line nationallicence Epicondylar axis nationallicence Talbot Simon Western Health, Melbourne, VIC, Australia aut Dimitriou Pandelis Western Health, Melbourne, VIC, Australia aut Radic Ross Western Health, Melbourne, VIC, Australia aut Zordan Rachel Warringal Private Hospital, Melbourne, VIC, Australia aut Bartlett John Warringal Private Hospital, Melbourne, VIC, Australia aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/11(2015-11-01), 3306-3316 0942-2056 23:11<3306 2015 23 167 https://doi.org/10.1007/s00167-014-3137-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3137-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Talbot Simon Western Health, Melbourne, VIC, Australia aut NATIONALLICENCE 700 1- Dimitriou Pandelis Western Health, Melbourne, VIC, Australia aut NATIONALLICENCE 700 1- Radic Ross Western Health, Melbourne, VIC, Australia aut NATIONALLICENCE 700 1- Zordan Rachel Warringal Private Hospital, Melbourne, VIC, Australia aut NATIONALLICENCE 700 1- Bartlett John Warringal Private Hospital, Melbourne, VIC, Australia aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/11(2015-11-01), 3306-3316 0942-2056 23:11<3306 2015 23 167