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KMID : 0359619940060020158
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Journal of Korean Knee Society
1994 Volume.6 No. 2 p.158 ~ p.164
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Standardization of Preoperative Radiography for Total Knee Arthroplasty
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안택진
김종관/안병우/박찬협
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Abstract
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Long term success after total knee arthroplasty(T.K.P.) is dependent on several factors, especially proper intraoperative component positioning. Numerous TKP alignment systems including intramedullary and extramedullary instruments are considered
by
many authors to be reliable methlods of producing proper component positioning.
Standardization of preoperative radiograghy for TKR is essential to getting appropriate axial alignment after compjonents positioning. So, we made AP and lateral radiograghs of entire lower extremity with the voluteer standing and included not
only
intraoperative femur A-P and lateral films into this study, but also A-P and lateral radiograhgs of 40 cadaveric fremoral skeletons. Analysis of those radiograhgs led us to the following results.
1. The vollunteer is positioned with both posterior condylar surfaces at the same level (neutral rotation). In neutral rotation, the line crossing bimalleollor tips is rotated average 24.6±2.6degrees externally.
2. On A-P radiogragh, the knee center is a point on the apex of the femoral notch on A-P radiograph and on the center of stem of femoral prosthesis template is positioned in place after sizing on the lateral film.
3. Mechanical axis crosses knee center and center of femoral head either on A-P radiograph or on lateral film.
4. anatomical axis crosses the apex of femoral notch and the center between inner conrtex surface on of the femoral isthmus on AP radiograph. On lateral radiograph, anatomic axis crosses a point 4mm anterior to posterior cortical inner surface
paralleling the mechanical axis.
5. Entry point of intramedully rod is a point that is about 8.2mm±1.9mm anterior to the border of femoral intercondylar notch through which the anatomic axiscrosses distal knee surface on lateral film.
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