The relationship of transepicondylar width with the distal and posterior femoral condyles and its clinical implications: A three-dimensional study

Lee, Merrill and Ho, Jade Pei Yuik and Chen, Jerry Yongqiang and Ng, Chung Kia and Yeo, Seng Jin and Merican, Azhar M. (2022) The relationship of transepicondylar width with the distal and posterior femoral condyles and its clinical implications: A three-dimensional study. Journal of Knee Surgery, 35 (03). pp. 280-287. ISSN 1538-8506, DOI https://doi.org/10.1055/s-0040-1713733.

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Abstract

Background Restoration of the anatomical joint line, while important for clinical outcomes, is difficult to achieve in revision total knee arthroplasty (rTKA) due to distal femoral bone loss. The objective of this study was to determine a reliable method of restoring the anatomical joint line and posterior condylar offset in the setting of rTKA based on three-dimensional (3D) reconstruction of computed tomography (CT) images of the distal femur. Methods CT scans of 50 lower limbs were analyzed. Key anatomical landmarks such as the medial epicondyle (ME), lateral epicondyle, and transepicondylar width (TEW) were determined on 3D models constructed from the CT images. Best-fit planes placed on the most distal and posterior loci of points on the femoral condyles were used to define the distal and posterior joint lines, respectively. Statistical analysis was performed to determine the relationships between the anatomical landmarks and the distal and posterior joint lines. Results There was a strong correlation between the distance from the ME to the distal joint line of the medial condyle (MEDC) and the distance from the ME to the posterior joint line of the medial condyle (MEPC) ( p < 0.001; r = 0.865). The mean ratio of MEPC to MEDC was 1.06 (standard deviation SD]: 0.07; range: 0.88-1.27) and that of MEPC to TEW was 0.33 (SD: 0.03; range: 0.25-0.38). Conclusions Our findings suggest that the fixed ratios of MEPC to TEW (0.33) and that of MEPC to MEDC (1.06) provide a reliable means for the surgeon to determine the anatomical joint line when used in combination.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Joint line; Posterior condylar offset; Distal femoral anatomy; Revision knee arthroplasty
Subjects: R Medicine > RD Surgery
Divisions: Faculty of Medicine > Orthopaedic Surgey Department
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 17 Aug 2022 05:09
Last Modified: 17 Aug 2022 05:09
URI: http://eprints.um.edu.my/id/eprint/33421

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