The digital measurements for femoral prosthesis in a Turkish population

Yıl 2013, Cilt: 7 Sayı: 1, 58 - 62, 01.10.2013

Barış Özgür Dönmez Bahadır Murat Demirel Umut Özsoy Hakan Bilbaşar Nurettin Oğuz Mustafa Ürgüden

https://doi.org/10.2399/ana.13.026

Öz

Objectives: This study was designed (i) to evaluate the angle between anatomical and mechanical axes of the femur and (ii) to compare shaft curve of the femur according to anatomical axis of femur with curve of the four femoral nail used in a Turkish population, in order to determine the safety degrees of distal femoral valgus cut for a routine surgical procedures.

Methods: Sixty-six right femurs, 68 left femurs and 4 femoral nails were measured. We measured the angle between anatomical axis and mechanical axis, the shaft curve of the femur according to anatomical axis on the femurs and shaft curve of the femoral nail on 4 femoral nails, which are commonly used in Turkey, using a digitizer system.

Results: In the 66 right femurs, the mean values of the angle between anatomical axis and mechanical axis was calculated as 6.386±0.820º and the mean value of the shaft curve of the femur according to anatomical axis was calculated as 16.713±2.371º. In the 68 left femurs, the mean value of angle between anatomical axis and mechanical axis was calculated as 6.915±0.712º and the mean value of the shaft curve of the femur according to anatomical axis was calculated as 16.148±2.689º. We calculated that curve of the 4 nails were Hipokrat 8.65º, Trigen 10.20º, Ortopro 6.38º and Recon 8.70º, respectively.

Conclusion: According to our results, new nails should be designed in the light of anatomical studies for each population. This will reduce the complications during surgery.

Anahtar Kelimeler

anatomical axes, cutting guide, femoral curve, femoral nail, mechanical axes

Kaynakça

• Harma A, Germen B, Karakas HM, Elmali N, Inan M. The com- parisn of femoral curves and curves of contemporary intramedullary nails. Surg Radiol Anat 2005;27:502-6.
• Dittmar M. Functional and postural lateral preferences in humans: interrelations and life-span age differences. Hum Biol 2002;74:569-85.
• Gill GW. Racial variation in the proximal and distal femur: heri- tability and forensic utility. J Forensic Sci 2001;46:791-9.
• Ballard ME. Anterior femoral curvature revisited: race assessment from the femur. J Forensic Sci 1999;44:700-7.
• Poilvache PL, Insall JN, Scuderi GR, Font-Rodriguez DE. Rotational landmarks and sizing of the distal femur in total knee arthroplasty. Clin Orthop Relat Res 1996;(335):35-46.
• Berger RA, Rubash HE, Seel MJ, Thompson WH, Crossett LS. Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res 1993;(286):40-7.
• Kurosawa H, Walker PS, Abe S, Garg A, Hunter T. Geometry and motion of the knee for implant and orthotic design. J Biomech 1985;18:487-99.
• Mantas JP, Bloebaum RD, Skedros JG, Hofmann AA. Implications of reference axes used for rotational alignment of the femoral com- ponent in primary and revision knee arthroplasty. J Arthroplasty 1992;7:531-5.
• Mensch JS, Amstutz HC. Knee morphology as a guide to knee replacement. Clin Orthop Relat Res 1975;(112):231-41.
• Seedhom BB, Longton EB, Wright V, Dowson D. Dimensions of the knee. Radiographic and autopsy study of sizes required by a knee prosthesis. Ann Rheum Dis 1972;31:54-8.
• Yoshioka Y, Siu D, Cooke TD. The anatomy and functional axes of the femur. J Bone Joint Surg Am 1987;69:873-80.
• Stoeckl B, Nogler M, Krismer M, Beimel C, de la Barrera JL, Kessler O. Reliability of the transepicondylar axis as an anatomical landmark in total knee arthroplasty. J Arthroplasty 2006;21:878- 82.
• Kharwadkar N, Kent RE, Sharara KH, Naique S. 5 degrees to 6 degrees of distal femoral cut for uncomplicated primary total knee arthroplasty: is it safe? Knee 2006;13:57-60.
• Bardakos N, Cil A, Thompson B, Stocks G. Mechanical axis can- not be restored in total knee arthroplasty with a fixed valgus resec- tion angle: a radiographic study. J Arthroplasty 2007;22:85-9.
• McGrory JE, Trousdale RT, Pagnano MW, Nigbur M. Preoperative hip to ankle radiographs in total knee arthroplasty. Clin Orthop Relat Res 2002;(404):196-202.
• Gausepohl T, Pennig D, Koebke J, Harnoss S. Antegrade femoral nailing: an anatomical determination of the correct entry point. Injury 2002;33:701-5.
• Steriopoulos K, Psarakis SA, Savakis C, Papakitsou E, Christakis D, Velivasakis E. Architecture of the femoral medullary canal and work- ing length for intramedullary nailing. Biomechanic indications for dynamic nailing. Acta Orthop Scand Suppl 1997;275:123-6.
• Harper MC, Carson WL. Curvature of the femur and the proxi- mal entry point for an intramedullary rod. Clin Orthop Relat Res 1987;(220):155-61.
• Ozsoy U, Demirel BM, Yildirim FB, Tosun O, Sarikcioglu L. Method selection in craniofacial measurements: advantages and disadvantages of 3D digitization method. J Craniomaxillofac Surg 2009;37:285-90.
• Dunn HK GV, Krackow KA. Instructional course lectures. Primary total knee arthroplasty: surgical technique and principles. In: Proceedings of the 68th Annual Meeting of the American Academy of Orthopaedic Surgeons, San Francisco, CA, February 28-March 4, 2001. p. 1-4.
• Ricci WM, Bellabarba C, Lewis R, et al. Angular malalignment after intramedullary nailing of femoral shaft fractures. J Orthop Trauma 2001;15:90-5.
• Leung KS, Procter P, Robioneck B, Behrens K. Geometric mis- match of the Gamma nail to the Chinese femur. Clin Orthop Relat Res 1996;(323):42-8.
• Egol KA, Chang EY, Cvitkovic J, Kummer FJ, Koval KJ. Mismatch of current intramedullary nails with the anterior bow of the femur. J Orthop Trauma 2004;18:410-5.
• Tang WM, Chiu KY, Kwan MF, Ng TP, Yau WP. Sagittal bow- ing of the distal femur in Chinese patients who require total knee arthroplasty. J Orthop Res 2005;23:41-5.