Abstract
Purpose
Few studies exist regarding sagittal alignment describing femur morphology in navigation-aided
surgery. This study investigated the three-dimensional (3D) sagittal femoral alignment
of the whole femur.
Methods
Seventy-three consecutive patients (59 females, 14 males, mean age: 76.1 years), yielding
140 femurs, were included in this study. A computed-tomography-based patient-specific
3D femur model was used to define a mechanical axis-based reference plane. Proximal
and distal femoral axis angles (PFA, DFA) to the reference plane were measured in
3D using custom software. PFA and DFA represent the proximal and distal inclination
of the femoral anatomical axis in sagittal plane, respectively.
Results
PFA (10.6 ± 1.5°) was greater than DFA (2.6 ± 1.6°; P < 0.0001). DFA in females (2.3 ± 1.4°) was smaller than in males (3.9 ± 1.7°; P < 0.0001).
Conclusion
This is the first report of measurement of femoral sagittal alignment related to both
3D anatomy and decision making of femoral flexion angle using navigation surgery for
total knee arthroplasty. This report shows a robust DFA measurement that could be
used as a template for femoral implants flexion angle when performing both conventional
and navigated total knee arthroplasty.
Keywords
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Article info
Publication history
Published online: January 30, 2023
Accepted:
December 7,
2022
Received in revised form:
November 13,
2022
Received:
May 14,
2021
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
