Intra- and interobserver reliability and agreement in three-dimensional computed tomography measurements of component positions after total knee arthroplasty |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan;2. Department of Orthopaedic Surgery, Chiba Rehabilitation Center, Chiba, Japan;1. Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea;2. Department of Orthopedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea;1. Sana Klinikum Rummelsberg, Department of Orthopaedic Surgery, Rummelsberg 71, 90592 Schwarzenbruck, Germany;2. Department of Orthopaedics, RWTH University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany;1. Research School of Electrical, Energy and Materials Engineering, Australian National University, Ian Ross Building 31, North Road, Acton, ACT, 2601;2. The Australian National University, Acton, ACT, 2601, Australia;3. University of New South Wales Canberra at ADFA, PO Box 7916, Canberra BC, ACT 2610, Australia;4. Faculty of Health, University of Canberra, Locked Bag 1, 2601, Australia;5. Trauma and Orthopaedic Research Unit, Canberra Hospital. Woden, ACT, 2606, Australia;1. Department of Orthopaedic Surgery and Traumatology, Hospital Clinic, Barcelona, Spain;2. Department of Human Anatomy, University of Barcelona Medical School, Barcelona, Spain;1. Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea;2. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;3. Yonsei Namu Orthopedic Clinic, Seoul, South Korea;4. Department of Anatomy, College of Medicine, Korea University, Seoul, South Korea;5. Joint Center, Barunsesang Hospital, Gyeonggi-do, South Korea;6. Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea |
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| Abstract: | BackgroundAccurate evaluation of the postoperative position of total knee arthroplasty (TKA) components is crucial in the analysis of the association of alignments with clinical outcomes. The aim of this study was to investigate the reliability of measurements of component positions after TKA using three-dimensional computed tomography (3D-CT) reconstruction.MethodsTwo independent orthopedic surgeons (an attending surgeon and a fellow) examined 30 knees after primary TKA. The coronal, sagittal, and rotational positions of the femoral and tibial components were measured twice at an interval of six weeks on 3D-CT images reconstructed using ZedKnee software. Mean intra- and interobserver differences of measured angles were calculated, and the intra- and interobserver reliability was determined using intraclass correlation coefficients (ICCs), with agreement assessed by Bland–Altman analysis.ResultsThe mean intraobserver difference between alignment measurements for femoral and tibial components was < 2° (range 0.23–1.17°) and the mean interobserver difference was < 1° (range 0.22–0.97°). The intra- and interobserver ICCs were > 0.8 for all component positions. The only systematic bias found in the intra- and interobserver agreements occurred for the sagittal position of the femoral component.ConclusionThree-dimensional-CT measurements of component positions after TKA showed good intra- and interobserver reliability for the femoral and tibial components in coronal, sagittal and rotational positions. The intra- and interobserver agreements were favorable for all but the sagittal position of the femur. These results suggest that 3D-CT can be used to evaluate the alignment of all TKA components except for the sagittal position of the femur. |
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