Relationship between the tibial mechanical axis and bony anatomical landmarks of the calf and foot as measured on radiographs obtained with a new laser-calibrated position

2013 ◽  
Vol 21 (4) ◽  
pp. 497-506
Author(s):  
Peiheng He ◽  
Qi Zhu ◽  
Zhaohui Zhang ◽  
Xuenong Zou ◽  
Dongliang Xu
Keyword(s):  
Mechanical Axis ◽  
Anatomical Landmarks ◽  
Tibial Mechanical Axis

Restoration of Constitutional Alignment in TKA with a Novel Osteotomy Technique

2019 ◽  
Vol 33 (02) ◽  
pp. 190-199
Author(s):  
Zhibing Wang ◽  
Xingwang Cheng ◽  
Yuan Zhang ◽  
Xia Zhang ◽  
Yue Zhou
Keyword(s):  
Distal Femur ◽  
Mechanical Axis ◽  
Femoral Shaft ◽  
Distal Femoral Osteotomy ◽  
Geometric Difference ◽  
Osteotomy Technique ◽  
Osteoarthritis Progression ◽  
Total Knee ◽  
Tibial Mechanical Axis ◽  
Constitutional Varus

AbstractMany studies have shown that restoration of the preoperative constitutional varus may lead to a normal knee status in total knee arthroplasty (TKA). It is also known that coronal femoral lateral bowing contributes to constitutional varus of the femoral shaft, and bilateral femoral lateral bowing (BFLB) can decelerate medial knee osteoarthritis progression. In this sense, the BFLB should be reserved in TKA. To date, no study has yet reported the technique to reserve BFLB in TKA. Our study showed that the proximal and distal femur had no significant geometric difference between patients with varus knees and BFLB (> 5°) and volunteers with healthy knees and straight femoral shaft. So, the virtual center of femoral head fell on the distal femoral mechanical axis (DMA) after accurate correction of the bowing, indicating that the DMA should be the femoral original constitutional mechanical axis (CA). Subsequently, the distal femoral osteotomy was performed perpendicular to DMA in TKA, and the postoperative angle formed by DMA and tibial mechanical axis (TMA) was measured to assess whether CA was restored successfully. In this study, the gap balance was achieved without medial collateral ligaments release, and the patient's CA was successfully restored (range of DMA–TMA angle 178.2°–179.9°). This study provides a novel technique to restore preoperative CA in patients with varus knees and BFLB. It is found that the distal femur should be cut perpendicular to DMA, so the lower limb alignment and soft tissue strains can be restored to the preoperative state, and the knees would be stable and in a natural status after TKA.

Evaluation of Accuracy in Ankle Center Location for Tibial Mechanical Axis Identification

2004 ◽  
Vol 17 (1) ◽  
pp. 23-29 ◽  
Author(s):  
L. Nofrini ◽  
M. Slomczykowski ◽  
F. Iacono ◽  
M. Marcacci
Keyword(s):  
Mechanical Axis ◽  
Center Location ◽  
Tibial Mechanical Axis

Evaluation of Accuracy in Ankle Center Location for Tibial Mechanical Axis Identification

2004 ◽  
Vol 17 (1) ◽  
pp. 23-29 ◽  
Author(s):  
L. Nofrini ◽  
M. Slomczykowski ◽  
F. Iacono ◽  
M. Marcacci
Keyword(s):  
Mechanical Axis ◽  
Center Location ◽  
Tibial Mechanical Axis

Is Valgus Cut Angle Based on Radiographic Measurements in Total Knee Arthroplasty Really Inaccurate? A Comparison of Two- and Three-Dimensional Measurements

2021 ◽  
Author(s):  
LiMing Liu ◽  
Kai Lei ◽  
Xin Chen ◽  
HuaQuan Fan ◽  
Liu Yang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Three Dimensional ◽  
Anatomical Landmarks ◽  
Radiographic Measurements ◽  
Significant Difference ◽  
Total Knee ◽  
Femoral Mechanical Axis ◽  
Anatomical Axis

AbstractRadiographs are widely used to measure distal femoral valgus cut angle (VCA) in total knee arthroplasty (TKA), but its accuracy is controversial. This study used three-dimensional (3D) reconstruction models to verify the accuracy of VCA measurements on radiographs, and explore the correlation of VCA with hip–knee–ankle (HKA) angle and lateral femoral bowing angle (FBA). A total of 444 osteoarthritis knees of 444 patients from August 2016 to June 2018 was included retrospectively. On radiographs, two-dimensional VCA (VCA-2D) was measured between the femoral mechanical axis and the distal femoral anatomical axis, and HKA was measured between the femoral mechanical axis and the tibial mechanical axis. On the coronal projection of computed tomography 3D models, the anatomical landmarks used for VCA-3D measurements were the same as those on the radiographs, FBA was measured between the proximal and distal femoral anatomical axis. The distributions of VCA-2D and VCA-3D were evaluated by means and variances. The correlation between HKA and VCA and between FBA and VCA was explored. There was a statistical difference between VCA-2D and VCA-3D (p < 0.001), but the deviation was very small (0.15 ± 0.69 degrees), 83.3% of the deviations were less than 1 degree. VCA would increase both in 2D and 3D with increasing of FBA and HKA varus. There was no statistically significant difference between VCA-2D and VCA-3D in patients with moderate varus knees (0–8 degrees of varus) and mild bowing femurs (FBA <5 degrees). Overall, the deviation caused by using radiography to measure VCA was negligible. VCA measurements using radiographs were accurate in patients with moderate varus knees and mildly bowed femurs. This study reflects level of evidence III.

scholarly journals Tibial Mechanical Axis Is Nonorthogonal to the Floor in Varus Knee Alignment

2021 ◽  
Vol 8 ◽  
pp. 237-242
Author(s):  
Stefano A. Bini ◽  
Christopher C. Chung ◽  
Scott A. Wu ◽  
Erik N. Hansen
Keyword(s):  
Mechanical Axis ◽  
Varus Knee ◽  
Knee Alignment ◽  
Tibial Mechanical Axis
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