title: Variability in Distal Femoral Anatomy in Patients Undergoing Total Knee Arthroplasty: Measurements on 13,546 Computed Tomography Scans.
abstract: Proper mechanical and rotational alignment plays an important role in achieving the success of the total knee arthroplasty (TKA). The purpose of the present study was to retrospectively determine with computed tomography (CT) the distal femoral valgus angle (DFVA) and femoral rotation angle (FRA). Our cohort included 13,546 CT scans of patients undergoing TKA. The average DFVA was 5.7 ± 2.3° (range from 1 to -16°) with 13.8% of patients identified as outliers. The distal FRA angle average was 3.3 ± 1.5° (range from -3 to 11°) with 2.8% of patients identified as outliers. These data can be useful in making orthopedic surgeons aware of the variability of femoral anatomy. Using the same cutting angle may lead to malposition of the femoral component.
authors.affiliation: Shiley Center for Orthopaedic Research and Education, Scripps Clinic, La jolla, California; Department of Orthopaedic Surgery, Balikesir University, Balıkesir Uşak yolu üzeri Çağış Yerleşkesi, Balikesir, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Meric
authors.affiliation: Shiley Center for Orthopaedic Research and Education, Scripps Clinic, La jolla, California; Department of Orthopaedic Surgery, Federal University of São Paulo, Sao Paulo, Brazil.
authors.forename: Guilherme C
authors.initials: GC
authors.lastname: Gracitelli
authors.affiliation: DePuy Synthes, Warsaw, Indiana.
authors.forename: Luke J
authors.initials: LJ
authors.lastname: Aram
authors.affiliation: Christ Hospital, Cincinnati, Ohio.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Swank
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Diego School of Medicine, La Jolla, California; Department of Orthopaedic Surgery, Scripps Clinic, La Jolla, California.
authors.forename: William D
authors.initials: WD
authors.lastname: Bugbee
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005269:Femur / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D012399:Rotation; D014057:Tomography, X-Ray Computed
keywords: distal femoral axis; distal femoral rotation; knee anatomy; limb alignment; total knee arthroplasty