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Updated: Aug 30, 2025
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Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy
Published on: February 17, 2023
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Preoperative Virtual Total Knee Arthroplasty Surgery Using a Computed Tomography-based 3-dimensional Model With
Shojiro Ishibashi1,2, Hideki Mizu-Uchi1,2, Shinya Kawahara2
1Department of Orthopedic Surgery, Saiseikai Fukuoka General Hospital, Chuo-ku, Fukuoka, Japan.
Arthroplasty Today
|August 29, 2022
Summary
Femoral component size in knee replacement surgery is influenced by cutting direction and alignment guides. Surgeons can adjust these factors to achieve optimal joint fit, avoiding issues like loose or tight gaps.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Total knee arthroplasty (TKA) aims to restore function and alleviate pain in patients with knee osteoarthritis.
- Accurate femoral component placement is crucial for successful TKA outcomes.
- Variations in surgical technique can lead to suboptimal component positioning and joint stability.
Purpose of the Study:
- To investigate how different femoral component placements affect component size in total knee arthroplasty.
- To analyze size differences resulting from various cutting directions, rotational alignments, and reference guide types.
- To provide data for optimizing femoral component selection and surgical technique.
Main Methods:
- Reconstruction of 3D bone models from CT scans of 101 osteoarthritic knees.
- Simulation of 20 different femoral component placements based on variations in cutting direction (relative to mechanical axis), rotational alignment (CEA vs. SEA), and anterior reference guide (CR vs. MR).
- Analysis of anteroposterior (AP) dimension differences from a standard position.
Main Results:
- Femoral component AP dimensions varied significantly across simulated placements, ranging from 54.3 mm to 62.5 mm.
- The largest deviation from the standard position was 7.1 mm, and the smallest was -1.2 mm.
- Flexion cutting direction, surgical epicondylar axis (SEA) alignment, and central reference guide (CR) were associated with smaller femoral component sizes.
Conclusions:
- Femoral component size is sensitive to cutting direction, rotational alignment, and reference guide choice.
- Understanding these influences allows surgeons to better predict and manage joint gap tightness or looseness.
- This research offers valuable insights for refining surgical techniques and improving patient outcomes in TKA.
