An epidemiological study to calculate angle between transepicondylar axis and posterior condylar axis of distal femur on MRI in Indian population

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.

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Anatomic Rotational Relationship of Distal Femur in Indian Population and its Implication in Total Knee Arthroplasty: A Magnetic Resonance Imaging Based Study

10.21203/rs.3.rs-876453/v1 ◽

2021 ◽

Author(s):

Balgovind S Raja ◽

Kshitij Gupta ◽

Sukhmin Singh ◽

Abdusamad V ◽

Hawaibam Nongdamba ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Magnetic Resonance ◽

Indian Population ◽

Distal Femur ◽

External Rotation ◽

Bony Landmarks ◽

Clinical Epicondylar Axis ◽

Posterior Condylar ◽

Total Knee ◽

Relationship Of

Abstract Background Bony landmarks for referencing distal femoral rotation may differ with ethnic populations. The study aims to find out the relationship of the bony landmarks of distal femur for rotational alignment of femoral component in total knee arthroplasty in Indian population and compare it with other ethnic groups. Methods Rotational relationship of distal femoral bony landmarks was studied using magnetic resonance images of 141 knees. The condylar twist angle (CTA), Whiteside's-posterior condylar axis angle (WL/PCL), Whiteside's-anatomical epicondylar angle (WL/A-EA) and difference between the two epicondylar axes (S-EA/A-EA) were measured. The effect of gender, side and age of these relationships was analyzed. Results The mean CTA, WL/A-EA/WL/PCL and A-EA/S-EA was found to be 5.59 ± 2°, 89.38 ± 2.66°, 5.44 ± 2.88°, 3.11 ± 0.54° respectively. A-EA/S-EA was found to be lower in younger population as compared to the older population. Rest none of the variables showed any significant difference when compared against age, sex or side. Conclusion The posterior condylar axis was 5.59˚ externally rotated in relation to clinical epicondylar axis. About 2.5° of added external rotation is required in jigs using the conventional 3° of inbuilt external rotation, if clinical epicondylar axis is taken as reference for apt placement of the femoral component.

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

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117s00104 ◽

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

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Rotational assessment of distal femur and its relevance in total knee arthroplasty: analysis by magnetic resonance imaging

Radiologia Brasileira ◽

10.1590/0100-3984.2014.0037 ◽

2015 ◽

Vol 48 (5) ◽

pp. 282-286 ◽

Cited By ~ 7

Author(s):

Fabricio Bolpato Loures ◽

Sebastião Furtado Neto ◽

Robson de Lima Pinto ◽

André Kinder ◽

Pedro José Labronici ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Distal Femur ◽

Imaging System ◽

Mean Value ◽

Resonance Imaging ◽

Transepicondylar Axis ◽

Mean Values ◽

Posterior Condylar ◽

The Mean

AbstractObjective:To define the distal femur rotation pattern in a Brazilian population, correlating such pattern with the one suggested by the arthroplasty instruments, and analyzing the variability of each anatomic parameter.Materials and Methods:A series of 101 magnetic resonance imaging studies were evaluated in the period between April and June 2012. The epidemiological data collection was performed with the aid of the institution's computed imaging system, and the sample included 52 male and 49 female patients. The measurements were made in the axial plane, with subsequent correlation and triangulation with the other plans. The posterior condylar line was used as a reference for angle measurements. Subsequently, the anatomical and surgical transepicondylar axes and the anteroposterior trochlear line were specified. The angles between the reference line and the studied lines were calculated with the aid of the institution's software.Results:The mean angle between the anatomical transepicondylar axis and the posterior condylar line was found to be 6.89°, ranging from 0.25° to 12°. For the surgical transepicondylar axis, the mean value was 2.89°, ranging from –2.23° (internal rotation) to 7.86°, and for the axis perpendicular to the anteroposterior trochlear line, the mean value was 4.77°, ranging from –2.09° to 12.2°.Conclusion:The anatomical transepicondylar angle showed mean values corresponding to the measurement observed in the Caucasian population. The utilized instruments are appropriate, but no anatomical parameter proved to be steady enough to be used in isolation.

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

The Journal of Arthroplasty ◽

10.1016/j.arth.2006.02.171 ◽

2006 ◽

Vol 21 (8) ◽

pp. 1141-1146 ◽

Cited By ~ 23

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

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Bone mineral density in healthy adult Indian population: the Chandigarh Urban Bone Epidemiological Study (CUBES)

Archives of Osteoporosis ◽

10.1007/s11657-020-00868-4 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Anshita Aggarwal ◽

Rimesh Pal ◽

Sanjay Kumar Bhadada ◽

Sant Ram ◽

Abhilasha Garg ◽

...

Keyword(s):

Bone Mineral Density ◽

Epidemiological Study ◽

Bone Mineral ◽

Indian Population ◽

Healthy Adult ◽

Mineral Density

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Variant Anatomy of Hypoglossal Canal: An Osteological Study in North Indian Population

Academia Anatomica International ◽

10.21276/aanat.2020.6.1.9 ◽

2020 ◽

Vol 6 (1) ◽

pp. 40-42

Author(s):

Yadav S ◽

Pandey P ◽

Pasricha N ◽

Bhatnagar R

Keyword(s):

Clinical Relevance ◽

Indian Population ◽

North Indian Population ◽

Hypoglossal Canal ◽

Posterior Condylar ◽

Human Skulls ◽

The Right ◽

Variant Anatomy

Introduction: To assess the presence of duplicated hypoglossal canal. Subjects and Methods: A total of 80 dried human skulls were collected from the Anthropology lab of the department of Anatomy K.G.M.U.,U. P., Lucknow, India. The skulls were examined for duplicated hypoglossal canal and presence of posterior condylar canal. Theskulls were closely inspected with the use of hand lens. Results: We observed bilateral duplicated hypoglossal canal in 3 skulls (3.75%), Unilateral duplication was seen in 15 skulls (18.75%) [i.e.7 on the right side and 8 on the left side]. We observed that the presence of duplicated hypoglossal canal was mostly associated with the presence of posterior condylar canal. Conclusion: Duplicated hypoglossal canal in humans may result in minor degrees of alterations in the movements of the tongue due to entrapment of nerve during ossification. The clinical relevance of this knowledge is important for radiologists and neurosurgeons.

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

The Journal of Knee Surgery ◽

10.1055/s-0039-1688931 ◽

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.

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