J Korean Knee Soc.
2003 Dec;15(2):140-146.
Rotational Axis in Total Knee Arthroplasty: Transepicondylar axis and Anteroposterior axis of Femur
- Affiliations
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- 1Department of Orthopaedics, Chonnam National University Hospital, Gwangju, Korea. eksong@chonnam.ac.kr
Abstract
- PURPOSE: We compared the tansepicondylar axis and the anteroposterior axis used as the references for the rotational axis of the femur when performing total knee arthroplasty and determined effect of varus deformity on two axes. MATERIALS AND METHODS: This study was conducted in 49 patients (69 cases of knees) with osteoarthritis who underwent preoperative computerized tomography (CT). The control group included 53 patients having no arthritis (53 cases) who underwent preoperative MRI for meniscal injury. On CT and MRI images, angle between tansepicondylar axis and the posterior condylar axis (posterior epicondylar angle) and angle between anteroposterior axis and posterior condylar axis (anteroposterior angle) were measured. Then, the data of two groups were compared. RESULTS: The average posterior epicondylar angle in the knee osteoarthritis group was 5.4 degrees +/-1.8, whereas that in the control group was 5.9 degrees +/- 1.6. The average anteroposterior angle in the osteoarthritis group was 3.8 degrees +/-1.6, whereas it was 3.9 degrees +/- 1.5 in the control group showing a significant difference from westerners. There was significant difference between posterior epicondylar angle and anteroposterior angle. But, no significant difference was seen in posterior epicondylar angle and anteroposterior angle between two groups. CONCLUSION: According to this study, the transepicondylar axis showed an average external rotation of 5.4 degrees , which was larger than 3 degrees recommended in usual total knee arthroplasty. The anteroposterior axis showed an average external rotation of 3.8 degrees . Varus deformity due to osteoarthritis had no significant effect on two axes. When femoral component is inserted, using only one axis to obtain correct rotational alignment caused problems because of considerable individual differences of two axes and we should consider two axes for correct rotational alignment.
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