Inter-observer precision and physiologic variability of MRI landmarks used to determine rotational alignment in conventional and patient-specific TKA

Andrew Park, Denis Nam, Michael V. Friedman, Stephen T. Duncan, Travis J. Hillen, Robert L. Barrack

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Preoperative planning for patient-specific guides (PSGs) in total knee arthroplasty (TKA) requires identification of anatomic landmarks on three-dimensional imaging studies. The aim of this study was to assess the accuracy and precision with which landmarks commonly used to determine rotational alignment in TKA can be identified on magnetic resonance imaging (MRI). Two orthopedic surgeons and two musculoskeletal radiologists independently reviewed a sequential series of 114 MRIs of arthritic knees. The magnitude of interobserver variability was high, suggesting an inherent risk of inconsistency when these landmarks are used in PSG fabrication. Additionally, there was a high degree of physiologic variation among patients, indicating that assuming standard relationships among anatomic landmarks when placing TKA components may lead to rotational malalignment relative to each patient's native anatomy.

Original languageEnglish
Pages (from-to)290-295
Number of pages6
JournalJournal of Arthroplasty
Volume30
Issue number2
DOIs
StatePublished - Feb 1 2015

Keywords

  • Anatomic landmarks in TKA
  • Malrotation
  • Patient-specific TKA
  • Physiologic variability
  • Rotational alignment

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