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Interethnic variability in distal femoral torsion Multicentre study of 515 CT scans of the distal femur
Author(s):
Cavaignac E. (France)
,
Cavaignac E. (France)
Affiliations:
reina n.
,
reina n.
Affiliations:
Murgier j.
,
Murgier j.
Affiliations:
Chiron p.
Chiron p.
Affiliations:
ESSKA Academy. cavaignac e. May 9, 2018; 209594; P10-213 Topic: Anatomy
Dr. etienne cavaignac
Dr. etienne cavaignac
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Abstract
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Objectives: Distal femoral torsion (DFT) is defined as the angle between the posterior condyle line and the transepicondylar axis. This angle must be taken into consideration when performing total knee arthroplasty (TKA) as it affects the gap balance and patellar tracking. To our knowledge, no studies have been done to compare DFT between ethnic groups. We hypothesised that DFT displays interethnic variability. The purpose of this study was to study how the DFT varies as a function of ethnicity, age and sex.

Methods: We carried out a retrospective analysis of 515 CT scans of the femur from Asian and European patients. These CT scans had been performed to assess the vascular condition of the lower limbs. Subjects with bone and joint diseases (including osteoarthritis) were excluded. Four osteometric landmarks were defined based on standard bone landmarks used to measure DFT with Amira 3D imaging software. Descriptive statistics (mean, median and standard deviation values) were calculated. The Mann-Whitney test was used to compare the DFT in the two ethnic groups. The effects of age and side were assessed using Spearman's correlation coefficient. We also determined the number of cases with more than 3° difference (outliers) that would have occurred by choosing a fixed distal femoral rotation value (median in each group).

Results: We analysed scans from 259 Asians and 256 Europeans (53% male). The mean age was 55.3 ± 15.2 years. The mean DFT was 5.9° ± 2.5 (0-14°). The mean DFT angle in Asians was 1.1° larger than that in Europeans (p < 0.0001). Using the median DFT value in each group as the reference value, 33% of the Asians and 27% of the Europeans could be considered outliers. Age and side had no effect on the DFT value (R = 0.03; p = 0.43).

Conclusions: There are significant interethnic differences in the DFT angle. Using a fixed distal femur rotation value during TKA could lead to rotational malalignment that alters the balance between the flexion and extension gaps.

Keywords:
variabilité, twist femoral, transepicondylar axis
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