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The femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty
INTRODUCTION: Conventionally, the depth of distal femoral resection in total knee arthroplasty is referenced from the most prominent distal femoral condyle. This surgical technique does not consider pathological alterations of articular surfaces or severity of knee deformity. It has been hypothesize...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264514/ https://www.ncbi.nlm.nih.gov/pubmed/35799307 http://dx.doi.org/10.1186/s43019-022-00159-x |
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author | Liu, David W. Martinez Martos, Sara Dai, Yifei Beller, Elaine M. |
author_facet | Liu, David W. Martinez Martos, Sara Dai, Yifei Beller, Elaine M. |
author_sort | Liu, David W. |
collection | PubMed |
description | INTRODUCTION: Conventionally, the depth of distal femoral resection in total knee arthroplasty is referenced from the most prominent distal femoral condyle. This surgical technique does not consider pathological alterations of articular surfaces or severity of knee deformity. It has been hypothesized that the femoral intercondylar notch is a clinically reliable and more accurate alternative landmark for the resection depth of the distal femur in primary total knee arthroplasty. METHODS: The resection depths of the distal femur at the medial and lateral femoral condyles and intercondylar notch were measured using computer navigation in 406 total knee arthroplasties. Variability between the bone resection depths was analyzed by standard deviation, 95% confidence interval and variance. Clinical follow-up of outcome to a minimum of 12 months was performed to further inform and validate the analysis. RESULTS: Mean resection depth of the medial condyle was 10.7 mm, of the lateral condyle 7.9 mm and of the femoral intercondylar notch 1.9 mm. The femoral intercondylar notch had the lowest variance in resection depth among the three landmarks assessed, with a variance of 1.7 mm(2) compared to 2.8 mm(2) for the medial femoral condyle and 5.1 mm(2) for the lateral femoral condyle. The intercondylar notch reference had the lowest standard deviation and 95% confidence interval. The resection depth referencing the notch was not sensitive to the degree of flexion contracture pre-operatively, whereas the medial and lateral condyles were. For varus deformed knees, distal femoral resection depth at the notch averaged 2 mm, which corresponds to the femoral prosthesis thickness at the intercondylar region, while for valgus deformed knees, the resection was flush with the intercondylar notch. CONCLUSIONS: The femoral intercondylar notch is a clinically practical and reproducible landmark for appropriate and accurate resection depth of the distal femur in primary total knee arthroplasty. LEVEL OF EVIDENCE: Level III: Retrospective cohort study. |
format | Online Article Text |
id | pubmed-9264514 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-92645142022-07-09 The femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty Liu, David W. Martinez Martos, Sara Dai, Yifei Beller, Elaine M. Knee Surg Relat Res Research Article INTRODUCTION: Conventionally, the depth of distal femoral resection in total knee arthroplasty is referenced from the most prominent distal femoral condyle. This surgical technique does not consider pathological alterations of articular surfaces or severity of knee deformity. It has been hypothesized that the femoral intercondylar notch is a clinically reliable and more accurate alternative landmark for the resection depth of the distal femur in primary total knee arthroplasty. METHODS: The resection depths of the distal femur at the medial and lateral femoral condyles and intercondylar notch were measured using computer navigation in 406 total knee arthroplasties. Variability between the bone resection depths was analyzed by standard deviation, 95% confidence interval and variance. Clinical follow-up of outcome to a minimum of 12 months was performed to further inform and validate the analysis. RESULTS: Mean resection depth of the medial condyle was 10.7 mm, of the lateral condyle 7.9 mm and of the femoral intercondylar notch 1.9 mm. The femoral intercondylar notch had the lowest variance in resection depth among the three landmarks assessed, with a variance of 1.7 mm(2) compared to 2.8 mm(2) for the medial femoral condyle and 5.1 mm(2) for the lateral femoral condyle. The intercondylar notch reference had the lowest standard deviation and 95% confidence interval. The resection depth referencing the notch was not sensitive to the degree of flexion contracture pre-operatively, whereas the medial and lateral condyles were. For varus deformed knees, distal femoral resection depth at the notch averaged 2 mm, which corresponds to the femoral prosthesis thickness at the intercondylar region, while for valgus deformed knees, the resection was flush with the intercondylar notch. CONCLUSIONS: The femoral intercondylar notch is a clinically practical and reproducible landmark for appropriate and accurate resection depth of the distal femur in primary total knee arthroplasty. LEVEL OF EVIDENCE: Level III: Retrospective cohort study. BioMed Central 2022-07-07 /pmc/articles/PMC9264514/ /pubmed/35799307 http://dx.doi.org/10.1186/s43019-022-00159-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Liu, David W. Martinez Martos, Sara Dai, Yifei Beller, Elaine M. The femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty |
title | The femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty |
title_full | The femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty |
title_fullStr | The femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty |
title_full_unstemmed | The femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty |
title_short | The femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty |
title_sort | femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264514/ https://www.ncbi.nlm.nih.gov/pubmed/35799307 http://dx.doi.org/10.1186/s43019-022-00159-x |
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