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
Percutaneous Endoscopic Transforaminal Lumbar Discectomy – An Early Experience
Percutaneous endoscopic spinal surgery performed in the awake state offers a new paradigm for treatment of symptomatic lumbar disc prolapse. We report the outcome of 23 patients who underwent this procedure. Visual analo...
Early Functional Outcome of Resection and Endoprosthesis Replacement for Primary Tumor around the Knee
We evaluated functional outcomes for patients who underwent surgery for resection and endoprosthesis replacement for primary tumours around the knee. We used the Musculoskeletal Tumour Society Scoring System (MSTS) for f...
Five Year Follow-up of One Stage Bilateral Total Hip Arthroplasty
We report on the medium term outcome of five patients (ten hips) who underwent one stage bilateral total hip arthroplasty. Both Harris Hip Scores and Oxford Hip Scores improved postoperatively as did range of motion. The...
Saturday Morning Palsy: Closed Traumatic Peripheral Neuropathy
Traumatic peripheral neuropathy can occur following fracture, dislocation, forceful reduction or direct compression. During the emergency medical relief mission for earthquake victims in Pakistan, between 30th Oct and 14...
A Comparison of Plain Radiography with Computer Tomography in Determining Coronal and Sagittal Alignments following Total Knee Arthroplasty
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 radi...