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KMID : 0359620170290020110
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Journal of Korean Knee Society
2017 Volume.29 No. 2 p.110 ~ p.114
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The Effect of Sagittal Knee Deformity on Preoperative Measurement of Coronal Mechanical Alignment during Total Knee Arthroplasty
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Shetty Gautam M.
Mullaji Arun
Khalifa Ahmed Adel
Ray Abhik
Nikumbha Vivek
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Abstract
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Purpose: The purpose of this prospective study was to determine correlation between coronal mechanical alignment measured on preoperative standing full-length radiographs and navigation during total knee arthroplasty (TKA) in the presence of an associated sagittal deformity (hyperextension and flexion deformity).
Materials and Methods: Coronal mechanical alignment measured on preoperative, standing, full-length, hip-to-ankle anteroposterior radiographs was compared with intraoperative measurements recorded with computer navigation in 200 primary navigated TKAs.
Results: The mean difference in mechanical alignment between the two techniques was significantly greater (p=0.001) in patients with an associated flexion deformity >10° when compared to knees with associated flexion deformity ≤10°; 48% of knees with a flexion deformity >10° had a difference of ≥3° between the full-length radiograph and navigation alignment measurements. There was a strong correlation between the radiographic and navigation measurement techniques.
Conclusions: The mean difference in coronal mechanical alignment between the two techniques was significantly higher in patients with an associated flexion deformity >10°. Hence, surgeons should take caution when relying on preoperative full-length radiographs for determining coronal mechanical alignment in patients with an associated flexion deformity >10° where using navigation may be more reliable.
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KEYWORD
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Knee, Arthroplasty, Computer-assisted surgery, Sagittal deformity, Alignment
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