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International Orthopaedics
Published in: International Orthopaedics 8/2017

01-08-2017 | Original Paper

Presence of rotational errors in long leg radiographs after total knee arthroplasty and impact on measured lower limb and component alignment

Authors: Günther Maderbacher, Clemens Baier, Achim Benditz, Ferdinand Wagner, Felix Greimel, Joachim Grifka, Armin Keshmiri

Published in: International Orthopaedics | Issue 8/2017

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Abstract

Purpose

Rotation of the lower limb in weight bearing long leg radiographs has a great impact on measured component and lower limb alignment parameters. We asked which rotational errors of long leg radiographs are present in a high volume centre and which radiological and clinical consequences arise regarding measured coronal component and lower limb alignment after total knee arthroplasty.

Methods

In 100 long leg radiographs coronal femoral and tibial component alignment and hip knee ankle angle (HKA) were measured. Present rotational errors in long leg radiographs were determined by fibular overlap and its impact on alignment parameters calculated.

Results

A mean internal rotation of 8.1° (9.3 SD) with a range between 36° of internal and 16° of external rotation was found in long leg radiographs. This resulted in mean differences between measurements before and after rotational correction regarding femoral and tibial component alignment and HKA of 0.6–0.8° (range 3.5° valgus and 1.6° varus error). Clinically, 11 out of 100 patients were wrongly assigned to either mal- or well-alignment (neutral mechanical alignment within ±3° varus or valgus).

Conclusion

Surgeons should be aware of potential rotational errors in long leg radiographs after total knee arthroplasty resulting in wrong measurements. In case of rotational errors, radiographs should be repeated or rotational corrections calculated. For study purposes only radiographs after rotational correction should be accepted.
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Metadata
Title
Presence of rotational errors in long leg radiographs after total knee arthroplasty and impact on measured lower limb and component alignment
Authors
Günther Maderbacher
Clemens Baier
Achim Benditz
Ferdinand Wagner
Felix Greimel
Joachim Grifka
Armin Keshmiri
Publication date
01-08-2017
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 8/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3408-3

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