Cartilage assessment using preoperative planning MRI for femoral component rotational alignment |
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| Institution: | 1. Aichi Medical University, Nagakute-city, Aichi Prefecture, Japan;2. Yoshida General Hospital, Akitakata-city, Hiroshima, Japan;3. Hiroshima University, Hiroshima, Japan;1. Department of Orthopedic Surgery, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA;2. Department of Clinical Operations, Mount Sinai Health System, USA;1. Division of Pediatric Orthopedic Surgery, Children’s Hospital Zagreb, Zagreb, Croatia;2. Department of Orthopedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia;3. Department of Technology, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia;4. Department of Forensic Medicine and Criminology, School of Medicine, University of Zagreb, Croatia;5. Department of Materials, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia;1. Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajiicho 465, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto 602-8566, Japan;2. Department of Sports and Para-Sports Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajiicho 465, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto 602-8566, Japan;1. Department of Orthopaedic Surgery, University of Maryland Medical Center, 110 South Paca Street 6th Floor Suite 300, Baltimore, MD 21201, United States;2. Orthopaedic Institute at University of Maryland St. Joseph’s Medical Center, 7601 Osler Dr., Towson, MD 21204, United States |
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| Abstract: | BackgroundSurgical planning of posterior referencing total knee arthroplasty (TKA) using computed tomography (CT) might lead to over-rotation of the femoral component because CT could not detect cartilage thickness of the posterior femoral condyle. The purpose of this study was to examine the rotational alignment difference of the femoral component between magnetic resonance imaging (MRI) and CT.MethodsFor elderly varus osteoarthritic patients, 66 varus osteoarthritic knee patients that underwent primary TKA were selected. Twenty-seven young patients who underwent primary anterior cruciate ligament reconstruction were selected as control. After the transepicondylar axis (CEA), the surgical epicondylar axis (SEA) and the posterior femoral condylar line (PCL) were drawn on CT and on MRI at the same angles as CT. Then, the practical PCL was drawn on MRI considering the cartilage thickness (the cartilage PCL). The angle between the SEA and the cartilage PCL (the cartilage posterior condylar angle (PCA)) was measured as preoperative planning. To investigate the accuracy of preoperative MRI measurement, the cartilage thickness on posterior femoral condyles was directly measured during TKA.ResultsThe cartilage PCA for varus osteoarthritic patients averaged 1.3 ± 1.3°. The cartilage PCA was 1.8 ± 1.0° significantly smaller than the bone PCA (the PCA measured on CT). Meanwhile, the cartilage PCA was 0.2 ± 0.4° significantly larger than the bone PCA in young people. The preoperative angle measurement on MRI strongly correlated with the direct measurement of cartilage thickness during TKA.ConclusionThere was 1.8° of divergence between MRI and CT in varus osteoarthritic patients due to cartilage degeneration of the medial femoral condyle. Cartilage assessment using MRI was useful for femoral component rotational alignment. |
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| Keywords: | Femoral component rotation Cartilage thickness Preoperative MRI Posterior reference Cruciate-retaining total knee arthroplasty |
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