Dargel, J., Pennig, L., Schnurr, C., Boese, C. K., Eysel, P. and Oppermann, J. (2016). Should we use hip-ankle radiographs to assess the coronal alignment after total knee arthroplasty? Orthopade, 45 (7). S. 591 - 597. NEW YORK: SPRINGER. ISSN 1433-0431

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Abstract

There is no consensus on whether hip-ankle radiographs or rather standardized aaEurop knee-radiographs should be used to assess implant position and coronal alignment after total knee arthroplasty (TKA). This study investigates whether implant position and alignment after TKA can reproducibly be assessed using aaEurop knee-radiographs rather than hip-ankle radiographs. This study was performed on 100 weight-bearing hip-ankle radiographs after conventional primary TKA. The true mechanical and anatomical femorotibial angle as well as coronal implant position was assessed on hip-ankle radiographs. The radiographs were then cropped to 80, 60 and 40 % of the leg-length and tibial coronal implant position, and the anatomical axis and a surrogate mechanical axis were obtained. The difference in the alignment parameters between the hip-ankle radiographs were statistically compared with the cropped radiographs and the inter-observer correlation coefficient (ICC) was calculated. The ICC for measurement of the mechanical femorotibial angle was higher in hip-ankle radiographs (0.95) when compared with a radiograph cropped to 40 % (0.61). There was a significant difference in the mechanical femorotibial angle between hip-ankle radiographs and any cropped radiograph. However, there were no significant differences in coronal implant position and the anatomical femorotibial angle between hip-ankle radiographs and any cropped radiograph. We conclude that standard aaEurop knee-radiographs are insufficient to assess the mechanical alignment following TKA. However, standard aaEurop knee-radiographs are appropriate to assess the implant position when referenced against the anatomical axes. Weight-bearing hip-ankle radiographs should be questioned as a routine after TKA.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Dargel, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pennig, L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schnurr, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boese, C. K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eysel, P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oppermann, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-270691
DOI: 10.1007/s00132-016-3264-7
Journal or Publication Title: Orthopade
Volume: 45
Number: 7
Page Range: S. 591 - 597
Date: 2016
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1433-0431
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
MECHANICAL ALIGNMENT; SURVIVAL; MALALIGNMENT; FAILUREMultiple languages
OrthopedicsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/27069

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