A Comparison of Plain Radiography with Computer Tomography in Determining Coronal and Sagittal Alignments following Total Knee Arthroplasty
Journal Title: Malaysian Orthopaedic Journal - Year 2017, Vol 11, Issue 2
Abstract
Introduction: Optimal coronal and sagittal component positioning is important in achieving a successful outcome following total knee arthroplasty (TKA). Modalities to determine post-operative alignment include plain radiography and computer tomography (CT) imaging. This study aims to determine the accuracy and reliability of plain radiographs in measuring coronal and sagittal alignment following TKA. Materials and Methods: A prospective, consecutive study of 58 patients undergoing TKA was performed comparing alignment data from plain radiographs and CT imaging. Hipknee- angle (HKA), sagittal femoral angle (SFA) and sagittal tibial angle (STA) measurements were taken by two observers from plain radiographs and compared with CT alignment. Intra- and inter-observer correlation was calculated for each measurement. Results: Intra-observer correlation was excellent for HKA (r>0.89) with a mean difference of <1.9°. The least intraobserver correlation was for SFA (mean r=0.58) with a mean difference of 8°. Inter observer correlation was better for HKA (r>0.95) and STA (r>0.8) compared to SFA (r=0.5). When comparing modalities (radiographs vs CT), HKA estimations for both observers showed the least maximum and mean differences while SFA observations were the least accurate. Conclusion: Radiographic estimation of HKA showed excellent intra- and inter-observer correlation and corresponds well with CT imaging. However, radiographic estimation of sagittal plane alignment was less reliably measured and correlated less with CT imaging. Plain radiography was found to be inferior to CT for estimation of biplanar prosthetic alignment following TKA.
Authors and Affiliations
Solayar GN, Chinappa J, Harris IA, Chen DB, Macdessi SJ
Keywords
Related Articles
- EP ID EP310560
- DOI 10.5704/MOJ.1707.006
- Views 87
- Downloads 0
Complete Recovery of Thoracic Myelopathy after Eleven Months of Paraplegia: A Case Report
Instances of neurological recovery after early decompression of the spine in non-traumatic spinal cord compression are well documented. We present a patient with paraplegia of 11 months’ duration due to atypical spinal t...
Is there a Significant Difference in Surgery and Outcomes between Unipolar and Bipolar Hip Hemiarthroplasty? A Retrospective Study of a Single Institution in Singapo
Objective: The aim was to compare outcomes differences between unipolar and bipolar hip hemiarthroplasty in one institution for the local geriatric population. Methodology: A retrospective review of 291 patients aged 7...
Giant Sacral Chondrosarcoma in an Elderly Male : A Case Report
Primary sacral tumours are rare, therefore experience of managing their associated complications are very limited. Effective surgical treatment of pelvic chondrosarcoma remains a major challenge for orthopaedic surgeons,...
Use of Titanium Elastic Nails in the Adult Diaphyseal Humerus Fractures
Introduction: Humerus shaft fractures in adults can be managed conservatively with functional braces or operatively with plate osteosynthesis or with intramedullary nailing. Conventionally humerus intramedullary nailing...
Outcome of Primary Cemented Bipolar Hemiarthroplasty compared with Dynamic Hip Screw in Elderly Patients with Unstable Intertrochanteric Fracture
Introduction: Although the treatment of choice for unstable intertrochanteric fractures in elderly patients has been internal fixation for a long time, several studies have shown mechanical and technical failures. Primar...