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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 9/2018

01-09-2018 | Knee Revision Surgery

The epicondylar ratio can be reliably used on X-ray of the knee to determine the joint line

Authors: Bernd Lutz, Angela Trubrich, Thomas Kappe, Heiko Reichel, Ralf Bieger

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2018

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Abstract

Purpose

The epicondylar ratio (ER) is used to restore the individual joint line (JL), especially in revision total knee arthroplasty. It was first described in magnetic resonance imaging (MRI) but is usually applied to a.p. radiographs of the knee for preoperative planning. The objective of the current study was to define reliable landmarks in MRI and X-ray images of the knee, which allow comparison of the image modalities. Furthermore, the correlation of the measured ER in MRI and X-rays of the knee was calculated.

Methods

A consecutive series of 87 patients who underwent an arthroscopical intervention of the knee were included into the present study. The lateral epicondyle was defined as the most lateral and distal prominence. On the medial side, the measurement was aligned to the epicondylar sulcus. The medial and lateral ER were calculated by dividing the perpendicular distance from the JL to the epicondyle by the transepicondylar distance. One observer determined the ER twice to calculate the intramethod intraobserver agreement, and a second observer obtained the intramethod interobserer agreement. The ER obtained from X-ray and MRI was compared to calculate the intermethod correlation.

Results

The average lateral ER was 0.29 on X-ray versus 0.28 on MRI. The average medial ER was 0.33 and 0.33, respectively. Intramethod agreement ranged from 0.66 to 0.88 and intermethod correlation from 0.49 to 0.57.

Conclusions

The ER can be determined reliably on MRI and X-ray images of the knee. The correlation of the ER in MRI and X-ray is fair.
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Metadata
Title
The epicondylar ratio can be reliably used on X-ray of the knee to determine the joint line
Authors
Bernd Lutz
Angela Trubrich
Thomas Kappe
Heiko Reichel
Ralf Bieger
Publication date
01-09-2018
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 9/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-018-3003-0

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