A Clinical Comparison of Patellar Tracking Using the Transepicondylar Axis and the Posterior Condylar Axis

2006 ◽  
Vol 21 (8) ◽  
pp. 1141-1146 ◽  
Author(s):  
D. Gordon Newbern ◽  
Philip M. Faris ◽  
Merrill A. Ritter ◽  
E. Michael Keating ◽  
John B. Meding ◽  
...  
Keyword(s):  
Patellar Tracking ◽  
Transepicondylar Axis ◽  
Posterior Condylar Axis ◽  
Clinical Comparison ◽  
Posterior Condylar

scholarly journals Distal Femoral Rotational Axes in Indian Knees

2009 ◽  
Vol 17 (2) ◽  
pp. 166-169 ◽  
Author(s):  
Arun B Mullaji ◽  
Amit K Sharma ◽  
Satyajit V Marawar ◽  
Anirudh F Kohli ◽  
Dharmendra P Singh
Keyword(s):  
Computed Tomography ◽  
Anatomic Landmarks ◽  
Transepicondylar Axis ◽  
Posterior Condylar Axis ◽  
Anteroposterior Axis ◽  
Whiteside’S Line ◽  
Posterior Condylar ◽  
Left And Right ◽  
The Mean ◽  
Posterior Condylar Angle

Purpose. To measure the angular relationships of distal femoral rotational axes in 100 normal Indian knees. Methods. 42 men and 8 women aged 26 to 40 (mean, 31) years, with 100 normal non-arthritic knees were recruited. Anatomic landmarks were measured using computed tomography. They included the posterior condylar axis, the transepicondylar axis, the anteroposterior axis (Whiteside's line), the posterior condylar angle (PCA), the Whiteside-epicondylar angle (W-EP), and the Whiteside-posterior condylar angle (W-PC). Results. The mean PCA, W-EP, and W-PC were 5°, 90.8°, and 95.8°, respectively. The mean femorotibial alignment was 179.6°. The differences between the left and right sides were significant only for the W-EP and W-PC. Only the PCA and W-EP were weakly correlated ( r=0.338, p=0.001). Conclusion. There are differences in distal femoral rotational axes among Indian, Caucasian, and Japanese knees. Our data can be used to evaluate changes in those axes in ageing or arthritic patients.

scholarly journals Consistency Between Posterior Condylar Axis (+3˚ external rotation) Line and Clinical Transepicondylar Axis Line in Primary Total Knee Arthroplasty

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0010
Author(s):  
Zeki Taşdemir ◽  
Hüseyin Bilgehan Çevik ◽  
Nurzat Elmalı ◽  
Özgür Baysal
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
External Rotation ◽  
Primary Total Knee Arthroplasty ◽  
Transepicondylar Axis ◽  
Posterior Condylar Axis ◽  
Rotation Line ◽  
Posterior Condylar ◽  
Total Knee ◽  
Primary Total Knee

Objectives: Purpose of this study is to as certain consistency between posterior condylar axis (PCA) + 3˚ external rotation line and clinical transepicondylar axis (cTEA) line in primary total knee arthroplasty cases. Materials-Methods: During surgery, following distal femoral cut PCA +3 degree external rotation line and cTEA line drawn on the distal femoral cutting surface by ruler and pencil. The both lines on distal femur were recorded by digital camera and relationship between lines was ascertained in reference to PCA +3 degree external rotation [parallel (P), Internal rotation (IR) and External Rotation (ER)]. Results: 9 knees of 9 patients [1 men, 8 women; average age 67 (59-80 age)] were constituted the study group. Evaluation results of the photographs revealed that clinical TEA line in comparison PCA +3 degrees external rotation line was ER in 9 knees (100%) whose mean angles 2.7˚ (1-6) and detected external roation with mean angle 4.7˚ (2-7) in 9 knees. Conclusion:: For determination of FC rotation in surgery setting, different results between cTEA and PCA + 3 degrees techniques possibly may due to disadvantages of techniques and anatomic variation of distal femur. Thus, using both techniques for check each other’s results seems unsafe. In custom made prosthesis, which can be done in the future it will be measured by CT. Keywords: Total knee arthroplasty, femoral component, rotational alignment, femoral transepicondylar axis, posterior condylar axis

Incidence of Femoral Component Malrotation Using Posterior Condylar Referencing in Total Knee Arthroplasty

2019 ◽  
Vol 33 (10) ◽  
pp. 971-977
Author(s):  
Diana K. Lee ◽  
Matthew J. Grosso ◽  
David P. Trofa ◽  
Julian J. Sonnenfeld ◽  
H. John Cooper ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
External Rotation ◽  
Prognostic Impact ◽  
Posterior Condylar Axis ◽  
Femoral Component Rotation ◽  
Component Rotation ◽  
Posterior Condylar ◽  
Total Knee

AbstractProper femoral component rotation in total knee arthroplasty (TKA) is important, given the prognostic impact of a poorly positioned component. The purpose of this observational study was to determine the incidence of femoral component malrotation using posterior condylar axis (PCA) referencing. A total of 100 knees in 92 patients with varus gonarthritis of the knee undergoing primary TKA using a standard medial parapatellar approach were evaluated intraoperatively. After distal femoral resection, the standard femoral sizing guide referencing the posterior condylar axis was used to set femoral component rotation. This was then compared with both the transepicondylar (TEA) and trochlear anteroposterior axes (TRAx). Disparites were recorded and corrected in line with the epicondylar axis. Rotational adjustment for addition of further external rotation was made in 13 (13.0%) cases. In seven cases, the medial pin sites were raised between 1 and 3 mm, and in six cases, the lateral pin site was lowered between 1 and 3 mm (based on risk of notching the femoral cortex). It is critical to not rely exclusively on the PCA to confirm rotational positioning of the femoral component as predicted by posterior condylar referencing guides. Intraoperative adjustment and confirmation using the TEA and TRAx occurred in 13% of primary TKA cases, which might have, otherwise, had a significant effect on the clinical outcome.

Relationship of the Posterior Condylar Line and the Transepicondylar Axis: A CT-Based Evaluation

2019 ◽  
Vol 33 (07) ◽  
pp. 673-677 ◽  
Author(s):  
David W. Fitz ◽  
Daniel J. Johnson ◽  
Matthew J. Hartwell ◽  
Ryan Sullivan ◽  
Tyler J. Keller ◽  
...  
Keyword(s):  
Demographic Data ◽  
Tibial Slope ◽  
Three Dimension ◽  
Knee Angle ◽  
Transepicondylar Axis ◽  
Posterior Condylar ◽  
Total Knee ◽  
The Mean ◽  
Relationship Of ◽  
Hip Knee Angle

AbstractPosterior condylar referencing, a common method for determining femoral axial orientation during total knee arthroplasty (TKA), relies upon an assumed consistent relationship between the posterior condylar line (PCL) and the transepicondylar axis (TEA) of 3 degrees rotation. A total of 3,010 computed tomography (CT) scans and three-dimension (3D)-reconstructions for presurgical creation of patient-matched TKA instrumentation were analyzed. Demographic data and five anthropometric measurements (hip–knee angle [HKA], distal femoral angle [DFA], proximal tibial angle [PTA], tibial slope [TS], and PCL–TEA relationship) were recorded for each scan. A logistic regression model was fit to assess interaction between the PCL–TEA relationship and demographic and radiological variables. The mean (standard deviation [SD]) PCL–TEA was +2.9 degrees (0.8 degree). The range varied between +0.5 and +16.5 degrees. In 2,758 knees (91.6%), the PCL–TEA was within 3 ± 1 degrees, whereas 252 knees (8.4%) fell outside this range. There were no significant demographic or anthropometric differences between those knees with PCL–TEA relationship between 3 ± 1 degrees and those falling outside that range. The posterior condyles of diseased knees undergoing TKA can be reliably used to indirectly reference the TEA of the distal femur with an error of only 1 degree in 92% of patients.

scholarly journals A comparison of femoral component rotation after total knee arthroplasty in Kanekasu radiographs, axial CT slices and 3D reconstructed images

2021 ◽  
Author(s):  
Emma L. Robertson ◽  
Martin Hengherr ◽  
Felix Amsler ◽  
Michael T. Hirschmann ◽  
Dominic T. Mathis
Keyword(s):  
Total Knee Arthroplasty ◽  
Gold Standard ◽  
Interrater Reliability ◽  
3D Ct ◽  
Intrarater Reliability ◽  
Transepicondylar Axis ◽  
Posterior Condyle ◽  
Component Rotation ◽  
Posterior Condylar ◽  
Total Knee

Abstract Objective To compare the posterior condylar angle measured with Kanekasu radiograph and 2D-CT with the gold standard 3D-CT following primary total knee arthroplasty (TKA). Methods Eighty-two knees with pain following TKA were included in this retrospective study. Two independent raters measured the anatomical and surgical posterior condylar angles twice on each Kanekasu radiograph and 2D-CT. These measurements were compared against the 3D-CT measurement. The intra- and interrater reliability of the Kanekasu radiograph and 2D-CT and the correlation with 3D-CT were calculated. Results The intra- and interrater reliability for measurements of the anatomical posterior condyle angle for the Kanekasu radiograph and the 2D-CT were excellent for both raters (0.85–0.92). For the less experienced rater 1, the intrarater reliability was significantly better for 2D-CT than Kanekasu radiograph for measuring both the surgical (p < 0.01) and anatomical posterior condyle angles (p < 0.05). For the experienced rater 2, the intrarater reliability was significantly better for Kanekasu radiograph than 2D-CT for measurement of the surgical posterior condyle angle (p < 0.05). The correlation with 3D-CT is higher in 2D-CT than in Kanekasu radiograph (p < 0.01). While the Kanekasu radiograph predicts the 3D-CT angle with 65.9%, 2D-CT can measure the true angle with 82.9% certainty. Conclusion Measurements using the anatomical transepicondylar axis are easier to replicate compared to the surgical transepicondylar axis. In comparison with the gold standard 3D-CT, 2D-CT showed a significantly higher correlation with 3D-CT than the Kanekasu measurements. If 3D-CT is available, it should be preferred over 2D-CT and Kanekasu view radiograph for femoral component rotation measurements.

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