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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Proposing a precision-enhancing method for sagittal plane alignment during total knee arthroplasty.

Jisu Park1, Hyeongyu Lim2, Chong Bum Chang3

  • 1Department of Orthopaedic Surgery, SMG- SNU Boramae Medical Center, Seoul, Republic of Korea.

BMC Musculoskeletal Disorders
|July 9, 2025
PubMed
Summary

This study introduces a simple X-ray based sagittal planning method for total knee arthroplasty (TKA), achieving 80.6% accuracy for femoral and 95.7% for tibial components, offering a cost-effective alternative.

Keywords:
AlignmentPlanning methodSagittal alignmentTotal knee arthroplasty

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Radiology

Background:

  • Accurate component alignment in total knee arthroplasty (TKA) is vital for implant longevity.
  • Sagittal plane alignment in TKA is less understood compared to other planes.
  • Current alignment techniques may lack precision or require advanced technology.

Purpose of the Study:

  • To propose a preoperative sagittal planning technique for TKA using standard X-rays.
  • To validate the accuracy of this novel planning method.
  • To identify factors influencing deviations in component placement.

Main Methods:

  • Prospective review of 93 knees (71 patients) undergoing TKA.
  • Preoperative sagittal planning for femoral and tibial components using X-ray images.
  • Validation of planned versus actual postoperative component alignment (target difference: -2° to 2°).

Main Results:

  • 80.6% of femoral components and 95.7% of tibial components achieved target sagittal alignment.
  • Femoral components were often placed in greater flexion than planned.
  • No factors were identified that correlated with increased alignment discrepancies.

Conclusions:

  • The proposed X-ray based sagittal planning method is accurate for TKA.
  • This technique offers a practical, low-cost alternative to robotic-assisted surgery.
  • The method demonstrates high accuracy for tibial component placement and good accuracy for femoral components.