Abstract
BackgroundPreoperative planning is imperative for a successful total knee replacement. Determining the valgus angle for the distal femoral cut from the preoperative 2D radiograph is a very inexpensive method that can be used to achieve the native knee alignment during a total knee arthroplasty (TKA).ObjectiveThe aim of this study was to document the intra-observer and inter-observer reliability of the valgus angle determination for distal femur cut from a preoperative digital radiograph in a TKA.MethodsA total of 20 patients with bilateral grade 3-4 primary osteoarthritis were assessed independently by a medical student, five surgeons, of which one was a consultant with more than 20 years of experience, and four residents in varied levels of training. Full-length (pelvis to toes) weight-bearing radiographs of both lower limbs were obtained prior to the surgery. The measurements were made thrice at more than 24 hours interval without any possible knowledge of their own previous measurement or that of other surgeons. We assessed the angle between the mechanical and anatomical axis of both femurs.ResultsThe single measures intraclass correlation was found to be 0.733, showing that there is a moderate reliability among the six raters when single measures were considered, whereas the average measures intraclass correlation was found to be 0.943, showing that there is an excellent reliability among the six raters when average measures were considered.For intra-observer reliability, the single measures intraclass correlation showed that there is a good-to-excellent reliability between the three trials when single measures was considered. The averages measures intraclass correlation showed that there is an excellent reliability between the three trials when average measures was considered.ConclusionA very inexpensive method of determining valgus angle for distal femur cut was found to have a moderate-to-excellent inter-observer reliability and a good-to-excellent intra-observer reliability.
Highlights
Restoration of knee alignment is a key factor in determining the outcome of total knee arthroplasty [1]
The single measures intraclass correlation was found to be 0.733, showing that there is a moderate reliability among the six raters when single measures were considered, whereas the average measures intraclass correlation was found to be 0.943, showing that there is an excellent reliability among the six raters when average measures were considered
The averages measures intraclass correlation showed that there is an excellent reliability between the three trials when average measures was considered
Summary
Restoration of knee alignment is a key factor in determining the outcome of total knee arthroplasty [1]. A distal femoral cut made perpendicular to the MA restores the axis of the limb. The commonly used methods to resect the femur perpendicular to its MA depend on the surgeon. Most surgeons routinely use a fixed valgus cut angle of 5° or 6° or may determine the valgus resection angle of each individual patient from a preoperative full length standing long-leg radiograph [3], or navigation maybe. Determining the valgus angle for the distal femoral cut from the preoperative 2D radiograph is a very inexpensive method that can be used to achieve the native knee alignment during a total knee arthroplasty (TKA)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
