Reliability and Validity of the Femorotibial Mechanical Axis Angle in Primary Total Knee Arthroplasty: Navigation versus Weight Bearing or Supine Whole Leg Radiographs
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Purpose: To evaluate the reliability and validity of the femorotibial mechanical axis angle from radiographs in the weight bearing (WB) and supine positions compared with navigationmeasured values.Materials and Methods: Sixtyeight cases of navigationassisted total knee arthroplasty (TKA) were included. The pre and postoperative whole leg radiographs (WLRs) in WB and supine positions were compared with the initial and final navigation values.Results: The mean mechanical axis angle from the preoperative WBWLR and navigation were not statistically different (p=0.079) and were correlated strongly with each other (intraclass correlation [ICC], 0.818). However, on postoperative measurements, although the WBWLR and navigation values were not different (p=0.098), they were not correlated with each other (ICC, 0.093). The standard error of measurement was 1.8°±3.6° for the preoperative WBWLR and 2.5°±4.8° for the postoperative WBWLR. The validity that was determined by the BlandAltman plot was not acceptable for both pre and postoperative measurements.Conclusions: The preoperative WBWLR could provide accurate but not precise measurement value of the femorotibial mechanical axis angle for navigationassisted TKA, and postoperative measurements in navigation were not comparable with radiographic measurements. The lack of agreement was found between the radiographic and navigation measurements of the coronal alignment regardless of pre or postoperative evaluation although the accuracy was found acceptable. Level of Evidence : Level 4
Abstract
Purpose: To evaluate the reliability and validity of the femorotibial mechanical axis angle from radiographs in the weight bearing (WB) and supine positions compared with navigationmeasured values.Materials and Methods: Sixtyeight cases of navigationassisted total knee arthroplasty (TKA) were included. The pre and postoperative whole leg radiographs (WLRs) in WB and supine positions were compared with the initial and final navigation values.Results: The mean mechanical axis angle from the preoperative WBWLR and navigation were not statistically different (p=0.079) and were correlated strongly with each other (intraclass correlation [ICC], 0.818). However, on postoperative measurements, although the WBWLR and navigation values were not different (p=0.098), they were not correlated with each other (ICC, 0.093). The standard error of measurement was 1.8°±3.6° for the preoperative WBWLR and 2.5°±4.8° for the postoperative WBWLR. The validity that was determined by the BlandAltman plot was not acceptable for both pre and postoperative measurements.Conclusions: The preoperative WBWLR could provide accurate but not precise measurement value of the femorotibial mechanical axis angle for navigationassisted TKA, and postoperative measurements in navigation were not comparable with radiographic measurements. The lack of agreement was found between the radiographic and navigation measurements of the coronal alignment regardless of pre or postoperative evaluation although the accuracy was found acceptable. Level of Evidence : Level 4
참고문헌 (23)
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