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The position and orientation of total knee replacement components : a comparison of conventional radiographs, transverse 2D-CT slices and 3D-CT reconstruction

Hirschmann, M. T. and Konala, P. and Amsler, F. and Iranpour, F. and Friederich, N. F. and Cobb, J. P.. (2011) The position and orientation of total knee replacement components : a comparison of conventional radiographs, transverse 2D-CT slices and 3D-CT reconstruction. The Journal of bone and joint surgery. A, American volume, Vol. 93, H. 5. pp. 629-633.

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Official URL: http://edoc.unibas.ch/dok/A6003372

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Abstract

We studied the intra- and interobserver reliability of measurements of the position of the components after total knee replacement (TKR) using a combination of radiographs and axial two-dimensional (2D) and three-dimensional (3D) reconstructed CT images to identify which method is best for this purpose. A total of 30 knees after primary TKR were assessed by two independent observers (an orthopaedic surgeon and a radiologist) using radiographs and CT scans. Plain radiographs were highly reliable at measuring the tibial slope, but showed wide variability for all other measurements; 2D-CT also showed wide variability. 3D-CT was highly reliable, even when measuring rotation of the femoral components, and significantly better than 2D-CT. Interobserver variability in the measurements on radiographs were good (intraclass correlation coefficient (ICC) 0.65 to 0.82), but rotational measurements on 2D-CT were poor (ICC 0.29). On 3D-CT they were near perfect (ICC 0.89 to 0.99), and significantly more reliable than 2D-CT (p > 0.001). 3D-reconstructed images are sufficiently reliable to enable reporting of the position and orientation of the components. Rotational measurements in particular should be performed on 3D-reconstructed CT images. When faced with a poorly functioning TKR with concerns over component positioning, we recommend 3D-CT as the investigation of choice.
Faculties and Departments:03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument
UniBasel Contributors:Friederich, Niklaus F.
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:The Journal of Bone and Joint Surgery Inc.
ISSN:0021-9355
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:07 Jun 2018 14:07
Deposited On:25 Oct 2013 08:32

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