Implication of Changes in the Imaging Measurements after Mechanically Aligned Total Knee Arthroplasty
Objective Imaging measurements allow assessment of the mechanical alignment before and after total knee arthroplasty (TKA). The changes in radiographic parameters in each period of time within 1 year after TKA has been poorly understood. The purpose of this study was to examine the timing and causes...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-12-01
|
| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13456 |
| _version_ | 1811186222355185664 |
|---|---|
| author | Long Cheng Peng Ren Qingyuan Zheng Ming Ni Lei Geng Yi‐Ming Wang Guo‐Qiang Zhang |
| author_facet | Long Cheng Peng Ren Qingyuan Zheng Ming Ni Lei Geng Yi‐Ming Wang Guo‐Qiang Zhang |
| author_sort | Long Cheng |
| collection | DOAJ |
| description | Objective Imaging measurements allow assessment of the mechanical alignment before and after total knee arthroplasty (TKA). The changes in radiographic parameters in each period of time within 1 year after TKA has been poorly understood. The purpose of this study was to examine the timing and causes of imaging changes in lower extremity force lines after total knee arthroplasty with mechanical alignment. Methods A total of 93 mechanically‐aligned TKA were radiographically examined before, 3 days, 3 months, and 1 year after surgery. Radiographic parameters included hip‐knee angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), knee joint line orientation (KJLO), ankle joint line orientation (AJLO), the knee joint line relative to ankle joint line angle (KJLTA) and midpoints of the ankle distance (MAD). Paired t‐test were used to analyze the changes of these imaging parameters, By establishing a simple tibial model, the time points of changes in the imaging parameters after TKA was determined, with an attempt to understand the post‐TKA changes in these imaging parameters. Results Statistically significant differences were found between the preoperative data and the data measured 3 days after surgery in HKA, LDFA, MPTA, MAD, KJLTA, AJLO (P < 0.05) while KJLO exhibited no significant difference (P = 0.089). There existed significant differences between the data measured 3 days and the measurements taken 3 months after operation in HKA, MPTA, KJLTA, KJLO, AJLO (P < 0.05), whereas LDFA and MAD showed no significant difference (P > 0.05). Significant differences were revealed between the data measured 3 months and those collected 1 year after surgery in LDFA, MPTA, AJLO, KJLTA (P < 0.05) but HKA, KJLO, AJLO showed no significant differences (P > 0.05). The tibial model was made to look into the changes in postoperative imaging parameters. ΔMAD and postoperative AJLO were calculated to verify the model and hypothesis. Conclusions Postoperative changes in radiographic parameters and tibial models showed that the lower extremities were in an unnatural state within 1 year after TKA. The changes in the lower extremities force line were the results of the gradual adaptation of the lower extremities to TKA and the lateral swing of the extremities (3°) after surgery. Imaging data 1 year after surgery should be taken into account in the explanation of post‐TKA changes in lower limb force lines. |
| first_indexed | 2024-04-11T13:43:00Z |
| format | Article |
| id | doaj.art-68d8e6f79192475e96fdcd1ea40ebad5 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-11T13:43:00Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-68d8e6f79192475e96fdcd1ea40ebad52022-12-22T04:21:12ZengWileyOrthopaedic Surgery1757-78531757-78612022-12-0114123322332910.1111/os.13456Implication of Changes in the Imaging Measurements after Mechanically Aligned Total Knee ArthroplastyLong Cheng0Peng Ren1Qingyuan Zheng2Ming Ni3Lei Geng4Yi‐Ming Wang5Guo‐Qiang Zhang6Medical School of Chinese People's Liberation Army General Hospital Beijing ChinaDepartment of Orthopaedics, the First Medical Center Chinese People's Liberation Army General Hospital Beijing ChinaMedical School of Chinese People's Liberation Army General Hospital Beijing ChinaDepartment of Orthopaedics, the First Medical Center Chinese People's Liberation Army General Hospital Beijing ChinaDepartment of Orthopaedics, the First Medical Center Chinese People's Liberation Army General Hospital Beijing ChinaMedical School of Chinese People's Liberation Army General Hospital Beijing ChinaDepartment of Orthopaedics, the First Medical Center Chinese People's Liberation Army General Hospital Beijing ChinaObjective Imaging measurements allow assessment of the mechanical alignment before and after total knee arthroplasty (TKA). The changes in radiographic parameters in each period of time within 1 year after TKA has been poorly understood. The purpose of this study was to examine the timing and causes of imaging changes in lower extremity force lines after total knee arthroplasty with mechanical alignment. Methods A total of 93 mechanically‐aligned TKA were radiographically examined before, 3 days, 3 months, and 1 year after surgery. Radiographic parameters included hip‐knee angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), knee joint line orientation (KJLO), ankle joint line orientation (AJLO), the knee joint line relative to ankle joint line angle (KJLTA) and midpoints of the ankle distance (MAD). Paired t‐test were used to analyze the changes of these imaging parameters, By establishing a simple tibial model, the time points of changes in the imaging parameters after TKA was determined, with an attempt to understand the post‐TKA changes in these imaging parameters. Results Statistically significant differences were found between the preoperative data and the data measured 3 days after surgery in HKA, LDFA, MPTA, MAD, KJLTA, AJLO (P < 0.05) while KJLO exhibited no significant difference (P = 0.089). There existed significant differences between the data measured 3 days and the measurements taken 3 months after operation in HKA, MPTA, KJLTA, KJLO, AJLO (P < 0.05), whereas LDFA and MAD showed no significant difference (P > 0.05). Significant differences were revealed between the data measured 3 months and those collected 1 year after surgery in LDFA, MPTA, AJLO, KJLTA (P < 0.05) but HKA, KJLO, AJLO showed no significant differences (P > 0.05). The tibial model was made to look into the changes in postoperative imaging parameters. ΔMAD and postoperative AJLO were calculated to verify the model and hypothesis. Conclusions Postoperative changes in radiographic parameters and tibial models showed that the lower extremities were in an unnatural state within 1 year after TKA. The changes in the lower extremities force line were the results of the gradual adaptation of the lower extremities to TKA and the lateral swing of the extremities (3°) after surgery. Imaging data 1 year after surgery should be taken into account in the explanation of post‐TKA changes in lower limb force lines.https://doi.org/10.1111/os.13456Lower extremities force lineMechanical alignmentRadiographic parametersTibial modelTotal knee arthroplasty |
| spellingShingle | Long Cheng Peng Ren Qingyuan Zheng Ming Ni Lei Geng Yi‐Ming Wang Guo‐Qiang Zhang Implication of Changes in the Imaging Measurements after Mechanically Aligned Total Knee Arthroplasty Orthopaedic Surgery Lower extremities force line Mechanical alignment Radiographic parameters Tibial model Total knee arthroplasty |
| title | Implication of Changes in the Imaging Measurements after Mechanically Aligned Total Knee Arthroplasty |
| title_full | Implication of Changes in the Imaging Measurements after Mechanically Aligned Total Knee Arthroplasty |
| title_fullStr | Implication of Changes in the Imaging Measurements after Mechanically Aligned Total Knee Arthroplasty |
| title_full_unstemmed | Implication of Changes in the Imaging Measurements after Mechanically Aligned Total Knee Arthroplasty |
| title_short | Implication of Changes in the Imaging Measurements after Mechanically Aligned Total Knee Arthroplasty |
| title_sort | implication of changes in the imaging measurements after mechanically aligned total knee arthroplasty |
| topic | Lower extremities force line Mechanical alignment Radiographic parameters Tibial model Total knee arthroplasty |
| url | https://doi.org/10.1111/os.13456 |
| work_keys_str_mv | AT longcheng implicationofchangesintheimagingmeasurementsaftermechanicallyalignedtotalkneearthroplasty AT pengren implicationofchangesintheimagingmeasurementsaftermechanicallyalignedtotalkneearthroplasty AT qingyuanzheng implicationofchangesintheimagingmeasurementsaftermechanicallyalignedtotalkneearthroplasty AT mingni implicationofchangesintheimagingmeasurementsaftermechanicallyalignedtotalkneearthroplasty AT leigeng implicationofchangesintheimagingmeasurementsaftermechanicallyalignedtotalkneearthroplasty AT yimingwang implicationofchangesintheimagingmeasurementsaftermechanicallyalignedtotalkneearthroplasty AT guoqiangzhang implicationofchangesintheimagingmeasurementsaftermechanicallyalignedtotalkneearthroplasty |