The femoral anterior tangent line could serve as a reliable alternative reference axis for distal femoral rotational alignment in total knee arthroplasty: an MRI-based study
BackgroundThis study aimed to evaluate the reference value of the femoral anterior tangent (FAT) line as a guidance of distal femoral rotation on magnetic resonance images (MRI).MethodsWe retrospectively included 81 patients (106 knees) diagnosed as ailing from primary knee osteoarthritis. The indir...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2024.1363551/full |
| _version_ | 1797263055476752384 |
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| author | Shuzhen Li Shuzhen Li Shuzhen Li Haiquan Deng Haiquan Deng Lianjian Jiang Haibo Liang Jianchao Sun Jianchao Sun Youjia Xu |
| author_facet | Shuzhen Li Shuzhen Li Shuzhen Li Haiquan Deng Haiquan Deng Lianjian Jiang Haibo Liang Jianchao Sun Jianchao Sun Youjia Xu |
| author_sort | Shuzhen Li |
| collection | DOAJ |
| description | BackgroundThis study aimed to evaluate the reference value of the femoral anterior tangent (FAT) line as a guidance of distal femoral rotation on magnetic resonance images (MRI).MethodsWe retrospectively included 81 patients (106 knees) diagnosed as ailing from primary knee osteoarthritis. The indirect rotational axes including the FAT line, the perpendicular line to the anteroposterior axis (pAPA), and the posterior condylar axis (PCA) were identified on MRI, and their angles related to the clinical transepicondylar axis (cTEA) or surgical transepicondylar axis (sTEA) were measured. The patients were further divided into subgroups according to the Kellgren–Lawrence (K–L) grades, the joint-line convergence angle (JLCA), and the arithmetic hip-knee-ankle angle (aHKA) to assess the variance of different rotational reference axes.ResultsThe FAT line was −11.8° ± 3.6° internally rotated to the cTEA and −7.5° ± 3.6° internally rotated to the sTEA. The FAT/cTEA angle and the FAT/sTEA angle shared a similar frequency distribution pattern but a little greater variance to the pAPA/cTEA angle and the PCA/cTEA angle. The PCA/cTEA angle in the JLCA |x| ≥ 6° subgroup was significantly smaller than in the two other JLCA subgroups. The pAPA/cTEA angle and the PCA/cTEA angle also presented statistical significance within the aHKA subgroups. While the FAT/cTEA angle and the FAT/sTEA angle demonstrated superior stability among the different K–L grades, JLCA subgroups, and aHKA subgroups.ConclusionThe FAT line was less affected by the degree of knee osteoarthritis and lower limb alignment, which could serve as a reliable alternative reference axis for the distal femoral rotational alignment in total knee arthroplasty. |
| first_indexed | 2024-04-25T00:06:55Z |
| format | Article |
| id | doaj.art-64e02c86263e46b0aa7cc853be387b56 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-25T00:06:55Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-64e02c86263e46b0aa7cc853be387b562024-03-14T04:53:09ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2024-03-011110.3389/fsurg.2024.13635511363551The femoral anterior tangent line could serve as a reliable alternative reference axis for distal femoral rotational alignment in total knee arthroplasty: an MRI-based studyShuzhen Li0Shuzhen Li1Shuzhen Li2Haiquan Deng3Haiquan Deng4Lianjian Jiang5Haibo Liang6Jianchao Sun7Jianchao Sun8Youjia Xu9Department of Orthopaedic Surgery, The Second Affiliated Hospital, Soochow University, Suzhou, ChinaDepartment of Orthopaedic Surgery, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, Nanning, ChinaDepartment of Joint and Sports Medicine Surgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, ChinaDepartment of Orthopaedic Surgery, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, Nanning, ChinaDepartment of Joint and Sports Medicine Surgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, ChinaGraduate School, Youjiang Medical University for Nationalities, Baise, ChinaDepartment of Orthopaedic Surgery, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, Nanning, ChinaDepartment of Orthopaedic Surgery, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, Nanning, ChinaDepartment of Joint and Sports Medicine Surgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, ChinaDepartment of Orthopaedic Surgery, The Second Affiliated Hospital, Soochow University, Suzhou, ChinaBackgroundThis study aimed to evaluate the reference value of the femoral anterior tangent (FAT) line as a guidance of distal femoral rotation on magnetic resonance images (MRI).MethodsWe retrospectively included 81 patients (106 knees) diagnosed as ailing from primary knee osteoarthritis. The indirect rotational axes including the FAT line, the perpendicular line to the anteroposterior axis (pAPA), and the posterior condylar axis (PCA) were identified on MRI, and their angles related to the clinical transepicondylar axis (cTEA) or surgical transepicondylar axis (sTEA) were measured. The patients were further divided into subgroups according to the Kellgren–Lawrence (K–L) grades, the joint-line convergence angle (JLCA), and the arithmetic hip-knee-ankle angle (aHKA) to assess the variance of different rotational reference axes.ResultsThe FAT line was −11.8° ± 3.6° internally rotated to the cTEA and −7.5° ± 3.6° internally rotated to the sTEA. The FAT/cTEA angle and the FAT/sTEA angle shared a similar frequency distribution pattern but a little greater variance to the pAPA/cTEA angle and the PCA/cTEA angle. The PCA/cTEA angle in the JLCA |x| ≥ 6° subgroup was significantly smaller than in the two other JLCA subgroups. The pAPA/cTEA angle and the PCA/cTEA angle also presented statistical significance within the aHKA subgroups. While the FAT/cTEA angle and the FAT/sTEA angle demonstrated superior stability among the different K–L grades, JLCA subgroups, and aHKA subgroups.ConclusionThe FAT line was less affected by the degree of knee osteoarthritis and lower limb alignment, which could serve as a reliable alternative reference axis for the distal femoral rotational alignment in total knee arthroplasty.https://www.frontiersin.org/articles/10.3389/fsurg.2024.1363551/fulltotal knee arthroplastyfemoral anterior tangent linerotational alignmentmagnetic resonance imaginglower limb alignment |
| spellingShingle | Shuzhen Li Shuzhen Li Shuzhen Li Haiquan Deng Haiquan Deng Lianjian Jiang Haibo Liang Jianchao Sun Jianchao Sun Youjia Xu The femoral anterior tangent line could serve as a reliable alternative reference axis for distal femoral rotational alignment in total knee arthroplasty: an MRI-based study Frontiers in Surgery total knee arthroplasty femoral anterior tangent line rotational alignment magnetic resonance imaging lower limb alignment |
| title | The femoral anterior tangent line could serve as a reliable alternative reference axis for distal femoral rotational alignment in total knee arthroplasty: an MRI-based study |
| title_full | The femoral anterior tangent line could serve as a reliable alternative reference axis for distal femoral rotational alignment in total knee arthroplasty: an MRI-based study |
| title_fullStr | The femoral anterior tangent line could serve as a reliable alternative reference axis for distal femoral rotational alignment in total knee arthroplasty: an MRI-based study |
| title_full_unstemmed | The femoral anterior tangent line could serve as a reliable alternative reference axis for distal femoral rotational alignment in total knee arthroplasty: an MRI-based study |
| title_short | The femoral anterior tangent line could serve as a reliable alternative reference axis for distal femoral rotational alignment in total knee arthroplasty: an MRI-based study |
| title_sort | femoral anterior tangent line could serve as a reliable alternative reference axis for distal femoral rotational alignment in total knee arthroplasty an mri based study |
| topic | total knee arthroplasty femoral anterior tangent line rotational alignment magnetic resonance imaging lower limb alignment |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2024.1363551/full |
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