We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The sulcus line of the trochlear groove is more accurate than Whiteside's Line in determining femoral component rotation.
- Authors
Talbot, Simon; Dimitriou, Pandelis; Radic, Ross; Zordan, Rachel; Bartlett, John
- Abstract
<bold>Purpose: </bold>The sulcus line (SL) is a three-dimensional curve produced from multiple points along the trochlear groove. Whiteside's Line, also known as the anteroposterior axis (APA), is derived from single anterior and posterior points. The purposes of the two studies presented in this paper are to (1) assess the results from the clinical use of the SL in a large clinical series, (2) measure the SL and the APA on three-dimensional CT reconstructions, (3) demonstrate the effect of parallax error on the use of the APA and (4) determine the accuracy of an axis derived by combining the SL and the posterior condylar axis (PCA).<bold>Methods: </bold>In the first study, we assessed the SL using a large, single surgeon series of consecutive patients undergoing primary total knee arthroplasties. The post-operative CT scans of patients (n = 200) were examined to determine the final rotational alignment of the femoral component. In the second study, measurements were taken in a series of 3DCT reconstructions of osteoarthritic knees (n = 44).<bold>Results: </bold>The mean position of the femoral component in the clinical series was 0.6° externally rotated to the surgical epicondylar axis, with a standard deviation of 2.9° (ranges from -7.2° to 6.7°). On the 3DCT reconstructions, the APA (88.2° ± 4.2°) had significantly higher variance than the SL (90.3° ± 2.7°) (F = 5.82 and p = 0.017). An axis derived by averaging the SL and the PCA+3° produced a significant decrease in both the number of outliers (p = 0.03 vs. PCA and p = 0.007 vs. SL) and the variance (F = 6.15 and p = 0.015 vs. SL). The coronal alignment of the SL varied widely relative to the mechanical axis (0.4° ± 3.8°) and the distal condylar surface (2.6° ± 4.3°).<bold>Conclusions: </bold>The multiple points used to determine the SL confer anatomical and geometrical advantages, and therefore, it should be considered a separate rotational landmark to the APA. These findings may explain the high degree of variability in the measurement of the APA which is documented in the literature. Combining a geometrically correct SL and the PCA is likely to further improve accuracy.
- Subjects
FEMUR radiography; FEMUR surgery; FEMUR; ARTIFICIAL joints; COMPUTED tomography; KNEE diseases; OSTEOARTHRITIS; ROTATIONAL motion; TOTAL knee replacement; RETROSPECTIVE studies; ANATOMY
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2015, Vol 23, Issue 11, p3306
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-014-3137-8