Measuring tibial component rotation of TKA in MRI: What is reproducible?
Abstract Purpose Correct rotational alignment of components is crucial for the success of total knee arthroplasty (TKA). Defining landmarks on the tibia that allow for reproducible measurement of component rotation seems to be more challenging than on the femoral side. This study compares the reprod...
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Published in | The knee Vol. 22; no. 6; pp. 604 - 608 |
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Format | Journal Article |
Language | English |
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01.12.2015
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Abstract | Abstract Purpose Correct rotational alignment of components is crucial for the success of total knee arthroplasty (TKA). Defining landmarks on the tibia that allow for reproducible measurement of component rotation seems to be more challenging than on the femoral side. This study compares the reproducibility of three different measurement techniques. Scope A magnetic resonance imaging (MRI) analysis of 55 patients following TKA was conducted. The rotation of the tibial components was determined using three different reference lines: a tangent to the posterior tibial margin, the tibial epicondylar axis, and the tibial tubercle. Data were analyzed for intra- and inter-observer reliability using intra-class correlation coefficients (ICCs), and a variance comparison between measurement techniques via F-test. Results Highest reliability and lowest variances for measurement of tibial component rotation were achieved by relation to the tibial epicondylar axis and posterior tibial margin. The tibial tubercle proved to be less reliable (ICC 0.632 (interobserver) and 0.526 (intraobserver)), and variances were significantly higher in comparison with the other two techniques. Conclusion Based on the presented MRI data, measurements of the tibial component rotation are done best using the posterior tibial margin and the tibial epicondylar axis. The tibial tubercle measurement proved to be less reliable for this purpose. We suggest that all three reference lines will be used for assessment of a painful knee following TKA to allow for informed decision making and for choice of best treatment options for the patient. Level II, clinical study. |
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AbstractList | Purpose Correct rotational alignment of components is crucial for the success of total knee arthroplasty (TKA). Defining landmarks on the tibia that allow for reproducible measurement of component rotation seems to be more challenging than on the femoral side. This study compares the reproducibility of three different measurement techniques. Scope A magnetic resonance imaging (MRI) analysis of 55 patients following TKA was conducted. The rotation of the tibial components was determined using three different reference lines: a tangent to the posterior tibial margin, the tibial epicondylar axis, and the tibial tubercle. Data were analyzed for intra- and inter-observer reliability using intra-class correlation coefficients (ICCs), and a variance comparison between measurement techniques via F-test. Results Highest reliability and lowest variances for measurement of tibial component rotation were achieved by relation to the tibial epicondylar axis and posterior tibial margin. The tibial tubercle proved to be less reliable (ICC 0.632 (interobserver) and 0.526 (intraobserver)), and variances were significantly higher in comparison with the other two techniques. Conclusion Based on the presented MRI data, measurements of the tibial component rotation are done best using the posterior tibial margin and the tibial epicondylar axis. The tibial tubercle measurement proved to be less reliable for this purpose. We suggest that all three reference lines will be used for assessment of a painful knee following TKA to allow for informed decision making and for choice of best treatment options for the patient. Level II, clinical study. PURPOSECorrect rotational alignment of components is crucial for the success of total knee arthroplasty (TKA). Defining landmarks on the tibia that allow for reproducible measurement of component rotation seems to be more challenging than on the femoral side. This study compares the reproducibility of three different measurement techniques.SCOPEA magnetic resonance imaging (MRI) analysis of 55 patients following TKA was conducted. The rotation of the tibial components was determined using three different reference lines: a tangent to the posterior tibial margin, the tibial epicondylar axis, and the tibial tubercle. Data were analyzed for intra- and inter-observer reliability using intra-class correlation coefficients (ICCs), and a variance comparison between measurement techniques via F-test.RESULTSHighest reliability and lowest variances for measurement of tibial component rotation were achieved by relation to the tibial epicondylar axis and posterior tibial margin. The tibial tubercle proved to be less reliable (ICC 0.632 (interobserver) and 0.526 (intraobserver)), and variances were significantly higher in comparison with the other two techniques.CONCLUSIONBased on the presented MRI data, measurements of the tibial component rotation are done best using the posterior tibial margin and the tibial epicondylar axis. The tibial tubercle measurement proved to be less reliable for this purpose. We suggest that all three reference lines will be used for assessment of a painful knee following TKA to allow for informed decision making and for choice of best treatment options for the patient. Correct rotational alignment of components is crucial for the success of total knee arthroplasty (TKA). Defining landmarks on the tibia that allow for reproducible measurement of component rotation seems to be more challenging than on the femoral side. This study compares the reproducibility of three different measurement techniques. A magnetic resonance imaging (MRI) analysis of 55 patients following TKA was conducted. The rotation of the tibial components was determined using three different reference lines: a tangent to the posterior tibial margin, the tibial epicondylar axis, and the tibial tubercle. Data were analyzed for intra- and inter-observer reliability using intra-class correlation coefficients (ICCs), and a variance comparison between measurement techniques via F-test. Highest reliability and lowest variances for measurement of tibial component rotation were achieved by relation to the tibial epicondylar axis and posterior tibial margin. The tibial tubercle proved to be less reliable (ICC 0.632 (interobserver) and 0.526 (intraobserver)), and variances were significantly higher in comparison with the other two techniques. Based on the presented MRI data, measurements of the tibial component rotation are done best using the posterior tibial margin and the tibial epicondylar axis. The tibial tubercle measurement proved to be less reliable for this purpose. We suggest that all three reference lines will be used for assessment of a painful knee following TKA to allow for informed decision making and for choice of best treatment options for the patient. Correct rotational alignment of components is crucial for the success of total knee arthroplasty (TKA). Defining landmarks on the tibia that allow for reproducible measurement of component rotation seems to be more challenging than on the femoral side. This study compares the reproducibility of three different measurement techniques. A magnetic resonance imaging (MRI) analysis of 55 patients following TKA was conducted. The rotation of the tibial components was determined using three different reference lines: a tangent to the posterior tibial margin, the tibial epicondylar axis, and the tibial tubercle. Data were analyzed for intra- and inter-observer reliability using intra-class correlation coefficients (ICCs), and a variance comparison between measurement techniques via F-test. Highest reliability and lowest variances for measurement of tibial component rotation were achieved by relation to the tibial epicondylar axis and posterior tibial margin. The tibial tubercle proved to be less reliable (ICC 0.632 (interobserver) and 0.526 (intraobserver)), and variances were significantly higher in comparison with the other two techniques. Based on the presented MRI data, measurements of the tibial component rotation are done best using the posterior tibial margin and the tibial epicondylar axis. The tibial tubercle measurement proved to be less reliable for this purpose. We suggest that all three reference lines will be used for assessment of a painful knee following TKA to allow for informed decision making and for choice of best treatment options for the patient. Level II, clinical study. •Correct rotational alignment of components is crucial for success of total knee arthroplasty (TKA).•Defining landmarks on the tibia that allow for reproducible measurement of component rotation is challenging.•This study is the first to compare the reproducibility of three different measurement techniques via MRI.•Best reliability achieved with tibial epicondylar axis and posterior tibial margin; tibial tubercle was less reliable•We suggest that all three reference lines are used for assessment of a painful knee following TKA Abstract Purpose Correct rotational alignment of components is crucial for the success of total knee arthroplasty (TKA). Defining landmarks on the tibia that allow for reproducible measurement of component rotation seems to be more challenging than on the femoral side. This study compares the reproducibility of three different measurement techniques. Scope A magnetic resonance imaging (MRI) analysis of 55 patients following TKA was conducted. The rotation of the tibial components was determined using three different reference lines: a tangent to the posterior tibial margin, the tibial epicondylar axis, and the tibial tubercle. Data were analyzed for intra- and inter-observer reliability using intra-class correlation coefficients (ICCs), and a variance comparison between measurement techniques via F-test. Results Highest reliability and lowest variances for measurement of tibial component rotation were achieved by relation to the tibial epicondylar axis and posterior tibial margin. The tibial tubercle proved to be less reliable (ICC 0.632 (interobserver) and 0.526 (intraobserver)), and variances were significantly higher in comparison with the other two techniques. Conclusion Based on the presented MRI data, measurements of the tibial component rotation are done best using the posterior tibial margin and the tibial epicondylar axis. The tibial tubercle measurement proved to be less reliable for this purpose. We suggest that all three reference lines will be used for assessment of a painful knee following TKA to allow for informed decision making and for choice of best treatment options for the patient. Level II, clinical study. |
Author | Heyse, Thomas J Tibesku, Carsten O Stiehl, James B |
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CitedBy_id | crossref_primary_10_1186_s13018_018_0957_0 crossref_primary_10_1016_j_knee_2018_05_006 crossref_primary_10_1002_jmri_26874 crossref_primary_10_1007_s00167_021_06495_x crossref_primary_10_1186_s10195_023_00718_2 crossref_primary_10_1007_s00402_017_2837_1 crossref_primary_10_1007_s00402_015_2157_2 crossref_primary_10_1186_s13018_023_03705_9 crossref_primary_10_1186_s40634_021_00432_0 crossref_primary_10_2106_JBJS_22_00520 crossref_primary_10_1016_j_arth_2017_01_035 crossref_primary_10_1007_s00590_019_02423_5 crossref_primary_10_4055_cios_2017_9_3_280 crossref_primary_10_1007_s00167_018_5131_z |
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Keywords | Tibial rotation Total knee arthroplasty TKA MRI |
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Snippet | Abstract Purpose Correct rotational alignment of components is crucial for the success of total knee arthroplasty (TKA). Defining landmarks on the tibia that... Correct rotational alignment of components is crucial for the success of total knee arthroplasty (TKA). Defining landmarks on the tibia that allow for... Purpose Correct rotational alignment of components is crucial for the success of total knee arthroplasty (TKA). Defining landmarks on the tibia that allow for... PURPOSECorrect rotational alignment of components is crucial for the success of total knee arthroplasty (TKA). Defining landmarks on the tibia that allow for... |
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SubjectTerms | Aged Arthroplasty, Replacement, Knee - methods Confidence intervals Female Follow-Up Studies Humans Joint surgery Knee Knee Joint - pathology Knee Joint - physiopathology Knee Joint - surgery Knee Prosthesis Magnetic Resonance Imaging - methods Male Medical imaging Methods MRI Orthopedics Osteoarthritis, Knee - diagnosis Osteoarthritis, Knee - physiopathology Osteoarthritis, Knee - surgery Patients Range of Motion, Articular - physiology Reproducibility of Results Retrospective Studies Rotation Studies Tibia - pathology Tibia - surgery Tibial rotation TKA Total knee arthroplasty |
Title | Measuring tibial component rotation of TKA in MRI: What is reproducible? |
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