Application of 3D Femoral Mechanical Axis Measurement in Total Knee Arthroplasty
Objective To investigate the application of measuring the femoral valgus angle and intramedullary rod entry point on 3D models and 2D images in total knee arthroplasty(TKA).Methods Imaging data from 105 patients who underwent lower limb computed tomography angiography(CTA)were gathered.This cohort comprised 65 males and 40 females,with ages ranging from 26 to 69 years,averaging(52.40±3.22)years.Among these patients,49 underwent procedures on their left knee,while 56 underwent procedures on their right knee.The CT scans of these 105 patients were then imported into Mimics software(version 19.0)for the purpose of creating 3D reconstructions of the femur.Utilizing the Fluoroscopy Simulation tool,2D femoral images were derived from the 3D models.Subsequently,the femoral valgus angle and intramedullary rod entry point were measured on both the 3D models and the 2D images.The collected data were then analyzed using the Shapiro-Wilk test for statistical significance.Results(1)There was no statistically significant difference observed in the femoral valgus angle measurements between 3D models and 2D images(P＞0.05).However,notable statistical differences were found in the measurements of the intramedullary rod entry point,Whiteside's line,and the distance to the highest point of the intercondylar notch between 3D models and 2D images(P＜0.05).(2)Among the parameters measured on 3D models,significant statistical differences were evident in the femoral valgus angle,the position of the intramedullary rod entry point,and the distance to the highest point of the intercondylar notch between different genders(P＜0.05).Conversely,the distance between the intramedullary rod entry point and Whiteside's line did not demonstrate any statistically significant difference(P＞0.05).(3)The correlation analysis between age and the femoral valgus angle revealed a positive correlation with a correlation coefficient of r=0.54(P＜0.001).Conclusion The intramedullary rod entry point determined using Whiteside's line and the highest point of the intercondylar notch on 2D images is not a dependable reference for TKA.Consequently,data pertaining to the intramedullary rod entry point obtained from X-rays cannot provide precise parameters for TKA.However,the outcomes of measuring the femoral valgus angle on 2D images possess significant reference value and demonstrate variations in accordance with age and gender.
total knee arthroplastyfemoral alignmentfemoral valgus correction anglefemoral intramedullary rod entry point
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