Conventional Cutting guides reliability during Total Knee Replacement in coronal plane. A retrospective Study
ESSKA Academy. Leal-Blanquet J. 11/08/19; 284380; epEKA-44 Topic: Joint Replacement
Dr. Joan Leal-Blanquet
Dr. Joan Leal-Blanquet
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Conventional Cutting guides reliability during Total Knee Replacement in coronal plane. A retrospective Study

ePoster - epEKA-44

Topic: TKA

Leal-Blanquet J., Hinarejos P., Torres-Claramunt R., Sánchez-Soler J., Monllau J.C.
PSMar, Barcelona, Spain

Introduction: One of the treatments that has been postulated as the most effective to treat an evolved knee osteoarthritis has been the implantation of a total knee arthroplasty (TKA). For the implantation of this arthroplasty, some cutting guides are used, intra-operatively, in order to constantly reproduce the orientation that is planned in the preoperative period. However, these conventional cutting guides can potentially cause a (unintended) deviation of what was planned in the pre-operative study. This will cause a poor alignment of the femoral or tibial components or both, in the postoperative radiology.
Main objective: In our study we wanted to study the correlation with the intra-operatively sought angles, in the coronal plane, and the angles we observed in postoperative radiology, using conventional cutting guides.
Methods: Two different independent observers obtained measures. We measured the anatomical lateral distal femoral angle (aLDFA) and the mechanical medial proximal tibial angle (mMPTA) in coronal plane post-operatively and compared with the pre-operative planned angle.
Statistics: We use U-Mann-Whitney test for 2 category variables and Kruskal-Wallis test for 3 or more categories variables.
Type of study: This is a retrospective study. According to the authors´ guides, published in the Journal of Bone and Joint Surgery, this study corresponds to a level IV of scientific evidence.
Results: We analyzed 340 TKA with primary or secondary osteoarthritis, from January 2013 to January 2014. The mean error found in femoral cut was 1,89º (less valgus) and the mean error in tibial cut was 1,31º (more varus). The inter-observer correlation coefficient was 0,677. When comparisons between different variables were made, no statistical differences were observed (p-value>0.05).
Discussion: Other authors, in the literature, show almost the same results. Boonen et al. has a discrepancy around 1.8º in femoral cut and 1.7º in tibial cut. Leeuwen et al. has 1.2º in femoral cut and 0.4º in tibial cut.
Conclusion: In summary, we can conclude that the accuracy of conventional cutting guides is good enough and there is no a clear casual factor to explain the 1-2º of discrepancy between preoperative planning and postoperative measurements. In addition, there are some interesting correlations (with no statistical significance) in terms of body mass index, preoperative alignment in tibial cut and the amount of correction that could be highlighted.
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