DOI QR코드

DOI QR Code

Reliability and Validity of the Femorotibial Mechanical Axis Angle in Primary Total Knee Arthroplasty: Navigation versus Weight Bearing or Supine Whole Leg Radiographs

  • Kim, Seong Hwan (Department of Orthopedic Surgery, Chung-Ang University College of Medicine) ;
  • Park, Yong-Beom (Department of Orthopedic Surgery, Chung-Ang University College of Medicine) ;
  • Song, Min-Ku (Department of Orthopedic Surgery, Chung-Ang University College of Medicine) ;
  • Lim, Jung-Won (Department of Orthopedic Surgery, Chung-Ang University College of Medicine) ;
  • Lee, Han-Jun (Department of Orthopedic Surgery, Chung-Ang University College of Medicine)
  • 투고 : 2018.05.02
  • 심사 : 2018.08.09
  • 발행 : 2018.12.01

초록

Purpose: To evaluate the reliability and validity of the femorotibial mechanical axis angle from radiographs in the weight bearing (WB) and supine positions compared with navigation-measured values. Materials and Methods: Sixty-eight cases of navigation-assisted total knee arthroplasty (TKA) were included. The pre- and postoperative whole leg radiographs (WLRs) in WB and supine positions were compared with the initial and final navigation values. Results: The mean mechanical axis angle from the preoperative WBWLR and navigation were not statistically different (p=0.079) and were correlated strongly with each other (intraclass correlation [ICC], 0.818). However, on postoperative measurements, although the WBWLR and navigation values were not different (p=0.098), they were not correlated with each other (ICC, 0.093). The standard error of measurement was $1.8^{\circ}{\pm}3.6^{\circ}$ for the preoperative WBWLR and $2.5^{\circ}{\pm}4.8^{\circ}$ for the postoperative WBWLR. The validity that was determined by the Bland-Altman plot was not acceptable for both pre- and postoperative measurements. Conclusions: The preoperative WBWLR could provide accurate but not precise measurement value of the femorotibial mechanical axis angle for navigation-assisted TKA, and postoperative measurements in navigation were not comparable with radiographic measurements. The lack of agreement was found between the radiographic and navigation measurements of the coronal alignment regardless of pre- or postoperative evaluation although the accuracy was found acceptable. Level of Evidence : Level 4.

키워드

참고문헌

  1. Figgie HE 3rd, Goldberg VM, Figgie MP, Inglis AE, Kelly M, Sobel M. The effect of alignment of the implant on fractures of the patella after condylar total knee arthroplasty. J Bone Joint Surg Am. 1989;71:1031-9. https://doi.org/10.2106/00004623-198971070-00009
  2. Laskin RS. The classic: total condylar knee replacement in patients who have rheumatoid arthritis: a ten-year follow-up study: 1990. Clin Orthop Relat Res. 2008;466:2589-96. https://doi.org/10.1007/s11999-008-0462-6
  3. Weng YJ, Hsu RW, Hsu WH. Comparison of computerassisted navigation and conventional instrumentation for bilateral total knee arthroplasty. J Arthroplasty. 2009;24:668-73. https://doi.org/10.1016/j.arth.2008.03.006
  4. Stiehl JB, Komistek RD, Dennis DA, Paxson RD, Hoff WA. Fluoroscopic analysis of kinematics after posterior-cruciateretaining knee arthroplasty. J Bone Joint Surg Br. 1995;77:884-9.
  5. Dennis DA, Komistek RD, Mahfouz MR. In vivo fluoroscopic analysis of fixed-bearing total knee replacements. Clin Orthop Relat Res. 2003;(410):114-30.
  6. Suggs JF, Hanson GR, Park SE, Moynihan AL, Li G. Patient function after a posterior stabilizing total knee arthroplasty: cam-post engagement and knee kinematics. Knee Surg Sports Traumatol Arthrosc. 2008;16:290-6. https://doi.org/10.1007/s00167-007-0467-9
  7. Moschella D, Blasi A, Leardini A, Ensini A, Catani F. Wear patterns on tibial plateau from varus osteoarthritic knees. Clin Biomech (Bristol, Avon). 2006;21:152-8. https://doi.org/10.1016/j.clinbiomech.2005.09.001
  8. Ho FY, Ma HM, Liau JJ, Yeh CR, Huang CH. Mobile-bearing knees reduce rotational asymmetric wear. Clin Orthop Relat Res. 2007;462:143-9. https://doi.org/10.1097/BLO.0b013e31806dba05
  9. Pitto RP, Graydon AJ, Bradley L, Malak SF, Walker CG, Anderson IA. Accuracy of a computer-assisted navigation system for total knee replacement. J Bone Joint Surg Br. 2006;88:601-5.
  10. Rauh MA, Boyle J, Mihalko WM, Phillips MJ, Bayers-Thering M, Krackow KA. Reliability of measuring long-standing lower extremity radiographs. Orthopedics. 2007;30:299-303. https://doi.org/10.3928/01477447-20070401-14
  11. Yaffe MA, Koo SS, Stulberg SD. Radiographic and navigation measurements of TKA limb alignment do not correlate. Clin Orthop Relat Res. 2008;466:2736-44. https://doi.org/10.1007/s11999-008-0427-9
  12. Lutzner J, Gross AF, Gunther KP, Kirschner S. Reliability of limb alignment measurement for high tibial osteotomy with a navigation system. Eur J Med Res. 2009;14:447-50. https://doi.org/10.1186/2047-783X-14-10-447
  13. Dahabreh Z, Scholes CJ, Giuffre B, Coolican MR, Parker DA. Lack of agreement between computer navigation and post-operative 2-dimensional computed tomography (CT) measurements for component and limb alignment in total knee arthroplasty (TKA). Knee. 2016;23:137-43. https://doi.org/10.1016/j.knee.2015.07.009
  14. Kim SH, Lim JW, Ko YB, Song MG, Lee HJ. Comparison of ultra-congruent mobile- and fixed-bearing navigation-assisted total knee arthroplasty with minimum 5-year followup. Knee Surg Sports Traumatol Arthrosc. 2016;24:3466-3473. https://doi.org/10.1007/s00167-016-4147-5
  15. Matsuda S, Miura H, Nagamine R, Mawatari T, Tokunaga M, Nabeyama R, Iwamoto Y. Anatomical analysis of the femoral condyle in normal and osteoarthritic knees. J Orthop Res. 2004;22:104-9. https://doi.org/10.1016/S0736-0266(03)00134-7
  16. Lustig S, Lavoie F, Selmi TA, Servien E, Neyret P. Relationship between the surgical epicondylar axis and the articular surface of the distal femur: an anatomic study. Knee Surg Sports Traumatol Arthrosc. 2008;16:674-82. https://doi.org/10.1007/s00167-008-0551-9
  17. Walter SD, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. Stat Med. 1998;17:101-10. https://doi.org/10.1002/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E
  18. Harvill LM. Standard error of measurement. Educ Meas-Issues Pract. 1991;10:33-41.
  19. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307-10.
  20. Cooke TD, Scudamore RA, Bryant JT, Sorbie C, Siu D, Fisher B. A quantitative approach to radiography of the lower limb: principles and applications. J Bone Joint Surg Br. 1991;73:715-20.
  21. Willcox NM, Clarke JV, Smith BR, Deakin AH, Deep K. A comparison of radiological and computer navigation measurements of lower limb coronal alignment before and after total knee replacement. J Bone Joint Surg Br. 2012;94:1234-40. https://doi.org/10.2106/JBJS.K.00682
  22. Hauschild O, Konstantinidis L, Baumann T, Niemeyer P, Suedkamp NP, Helwig P. Correlation of radiographic and navigated measurements of TKA limb alignment: a matter of time? Knee Surg Sports Traumatol Arthrosc. 2010;18:1317-22. https://doi.org/10.1007/s00167-010-1144-y
  23. Choi WC, Lee S, An JH, Kim D, Seong SC, Lee MC. Plain radiograph fails to reflect the alignment and advantages of navigation in total knee arthroplasty. J Arthroplasty. 2011;26:756-64. https://doi.org/10.1016/j.arth.2010.07.020

피인용 문헌

  1. Cross-cultural adaptation and validation of the Korean version of the Central Sensitization Inventory in patients undergoing total knee arthroplasty for knee osteoarthritis vol.15, pp.12, 2018, https://doi.org/10.1371/journal.pone.0242912
  2. Postoperative laxity of the lateral soft tissue is largely negligible in total knee arthroplasty for varus osteoarthritis vol.29, pp.1, 2018, https://doi.org/10.1177/23094990211002002
  3. Efficacy and Safety of Intravenous Ferric Carboxymaltose in Patients with Postoperative Anemia Following Same-Day Bilateral Total Knee Arthroplasty: A Randomized Controlled Trial vol.10, pp.7, 2018, https://doi.org/10.3390/jcm10071457
  4. Preemptive Duloxetine Relieves Postoperative Pain and Lowers Wound Temperature in Centrally Sensitized Patients Undergoing Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial vol.10, pp.13, 2018, https://doi.org/10.3390/jcm10132809
  5. Efficacy of duloxetine compared with opioid for postoperative pain control following total knee arthroplasty vol.16, pp.7, 2018, https://doi.org/10.1371/journal.pone.0253641