Improved method for planning intramedullary guiding rod entry point in total knee arthroplasty

Arch Orthop Trauma Surg. 2014 May;134(5):693-8. doi: 10.1007/s00402-014-1943-6. Epub 2014 Feb 12.

Abstract

Background: To study the accuracy of using the deepest point of the intercondylar notch (DPIN) as a reference point for femoral intramedullary (IM) guiding rod entrance in total knee arthroplasty (TKA) with 3-D reconstruction in Chinese subjects.

Methods: A total of 50 normal femurs in 25 Chinese subjects (mean age 25.6 ± 2.9 years; range 18-29 years) were chosen from the lower extremities computed tomography digital imaging and communications in medicine (DICOM) database for this study. The DICOM data were imported into Mimics 10.0 software. A cylinder (radius = 4 mm; length = 20 cm) was used to simulate ideal insertion of a IM guiding rod into the femoral canal. DPIN was taken as a reference point for calculating the relative position of the rod's entry point.

Results: The mean rod entry point position in the coronal plane was 2.94 ± 1.12 mm (range 0.79-4.91 mm) medial and 6.01 ± 2.09 mm (range 2.49-9.51 mm) anterior to the DPIN, with no significant difference between sides. All potential angle errors were below 2°.

Conclusion: The results of this study show that the DPIN can serve as a reference for surgeons using an IM guide system in TKA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Arthroplasty, Replacement, Knee / methods*
  • Female
  • Femur / anatomy & histology
  • Femur / surgery
  • Fracture Fixation, Intramedullary
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Imaging, Three-Dimensional
  • Male
  • Models, Anatomic
  • Osteotomy / methods*
  • Tomography, X-Ray Computed
  • Young Adult