{"title":"The comparison of three dimensional and two dimensional evaluation of varus/valgus stress X-rays following total knee arthroplasty.","authors":"Hiroki Hijikata, Tomoharu Mochizuki, Keisuku Maeda, Osamu Tanifuji, Go Omori, Noriaki Yamamoto, Hiroyuki Kawashima","doi":"10.1186/s13018-025-05741-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to compare three-dimensional (3D) and two-dimensional (2D) evaluation of the stress X-rays following total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This prospective study analyzed 51 consecutive rTKAs (four males and 44 females, both aged 74 ± 6 years). Postoperative varus/valgus stress X-rays were taken at maximum manual varus/valgus stress during knee extension under anesthesia, and were analyzed three-dimensionally using a 3D-2D image matching technique with 3D bone and component models. The 3D models of the femur and tibia, along with component-bone constructs, were reconstructed from CT data using 3D modeling software. The 2D evaluation of varus/valgus stress X-rays were carried out directly on the stress X-rays. The varus/valgus angle (VV angle) between components, Medial joint opening (MJO) and lateral joint opening (LJO) were assessed under conditions of no stress, valgus stress, and varus stress.</p><p><strong>Results: </strong>The VV angles under no stress, valgus stress, and varus stress in 3D and 2D evaluation were 3.6 ± 1.1 / 3.6 ± 1.1°, -0.6 ± 1.6 / -0.6 ± 1.6°, 7.1 ± 1.9 / 6.8 ± 2.5°, respectively. The MJO in the non-stress condition and under valgus stress in 3D and 2D evaluation were 0.0 ± 0.5 / -1.8 ± 0.8 mm,1.4 ± 1.0 / -0.2 ± 1.4 mm, and the LJO in the non-stress condition and under varus stress in 3D and 2D evaluation were 0.9 ± 1.0 / -0.6 ± 1.0 mm, 3.5 ± 1.9 / 2.1 ± 1.9 mm, respectively.</p><p><strong>Conclusions: </strong>This prospective study revealed that the 3D evaluation of varus/valgus stress X-rays following total knee arthroplasty is equivalent to 2D evaluation in VV angles, whereas different from 2Devaluation in MJO and LJO.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"326"},"PeriodicalIF":2.8000,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954331/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Surgery and Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13018-025-05741-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The purpose of this study was to compare three-dimensional (3D) and two-dimensional (2D) evaluation of the stress X-rays following total knee arthroplasty (TKA).
Methods: This prospective study analyzed 51 consecutive rTKAs (four males and 44 females, both aged 74 ± 6 years). Postoperative varus/valgus stress X-rays were taken at maximum manual varus/valgus stress during knee extension under anesthesia, and were analyzed three-dimensionally using a 3D-2D image matching technique with 3D bone and component models. The 3D models of the femur and tibia, along with component-bone constructs, were reconstructed from CT data using 3D modeling software. The 2D evaluation of varus/valgus stress X-rays were carried out directly on the stress X-rays. The varus/valgus angle (VV angle) between components, Medial joint opening (MJO) and lateral joint opening (LJO) were assessed under conditions of no stress, valgus stress, and varus stress.
Results: The VV angles under no stress, valgus stress, and varus stress in 3D and 2D evaluation were 3.6 ± 1.1 / 3.6 ± 1.1°, -0.6 ± 1.6 / -0.6 ± 1.6°, 7.1 ± 1.9 / 6.8 ± 2.5°, respectively. The MJO in the non-stress condition and under valgus stress in 3D and 2D evaluation were 0.0 ± 0.5 / -1.8 ± 0.8 mm,1.4 ± 1.0 / -0.2 ± 1.4 mm, and the LJO in the non-stress condition and under varus stress in 3D and 2D evaluation were 0.9 ± 1.0 / -0.6 ± 1.0 mm, 3.5 ± 1.9 / 2.1 ± 1.9 mm, respectively.
Conclusions: This prospective study revealed that the 3D evaluation of varus/valgus stress X-rays following total knee arthroplasty is equivalent to 2D evaluation in VV angles, whereas different from 2Devaluation in MJO and LJO.
期刊介绍:
Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues.
Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications.
JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.