The EKA Femoral Rotation Focus Group has not identified a single best reference method to determine femoral component rotation , but surgeons mostly prefer the measured resection technique using at least two l and marks for cross-checking the rotation .
Malrotation of the femoral component after primary total knee arthroplasty ( TKA ) is one of the most important problems leading to painful TKA requiring revision surgery .
A comprehensive systematic review of the literature was performed to present current evidence on how to optimally place the femoral component in TKA .
4D-SPECT/CT in orthopaedics: a new method of combined quantitative volumetric 3D analysis of SPECT/CT tracer uptake and component position measurements in patients after total knee arthroplasty
Objective The purpose was to evaluate the intra- and inter-observer reliability of combined quantitative 3D-volumetric single-photon emission computed tomography (SPECT)/CT analysis including size , intensity and localisation of tracer uptake regions and total knee arthroplasty ( TKA ) position . Material s and methods Tc-99m-HDP-SPECT/CT of 100 knees after TKA were prospect ively analysed . The anatomical areas represented by a previously vali date d localisation scheme were 3D-volumetrically analysed . The maximum intensity was recorded for each anatomical area . Ratios between the respective value and the mid-shaft of the femur as the reference were calculated . Femoral and tibial TKA position ( varus – valgus , flexion – extension , internal rotation– external rotation ) were determined on 3D-CT . Two consultant radiologists/nuclear medicine physicians interpreted the SPECT/CTs twice with a 2-week interval . The inter- and intra-observer reliability was determined ( ICCs ) . Kappa values were calculated for the area with the highest tracer uptake between the observers . Results The measurements of tracer uptake intensity showed excellent inter- and intra-observer reliabilities for all regions ( tibia , femur and patella ) . Only the tibial shaft area showed ICCs < 0.89 . The kappa values were almost perfect ( 0.856 , p < 0.001 ; 95 % CI 0.778 , 0.922 ) . For measurements of the TKA position , there was strong agreement within and between the readings of the two observers ; the ICCs for the orientation of TKA components for inter- and intra-observer reliability were nearly perfect ( ICCs > 0.84 ) . Conclusion This combined 3D-volumetric st and ardised method of analysing the location , size and the intensity of SPECT/CT tracer uptake regions ( “ hotspots ” ) and the determination of the TKA position was highly reliable and represents a novel promising approach to biomechanics
The EKA Femoral Rotation Focus Group has not identified a single best reference method to determine femoral component rotation , but surgeons mostly prefer the measured resection technique using at least two l and marks for cross-checking the rotation .
Malrotation of the femoral component after primary total knee arthroplasty ( TKA ) is one of the most important problems leading to painful TKA requiring revision surgery .
A comprehensive systematic review of the literature was performed to present current evidence on how to optimally place the femoral component in TKA .