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Fixed 6° distal femoral cut consistently achieves neutral alignment for Asians, Caucasians, and Native Hawaiian/Pacific Islanders.
Abella, Maveric; Ong, Vera; Thorne, Tyler; Shimoda, Brent; Andrews, Samantha N; Nakasone, Cass K.
  • Abella M; John A Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA.
  • Ong V; John A Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA.
  • Thorne T; John A Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA.
  • Shimoda B; Department of Orthopedic Surgery, Straub Medical Center, 888 South King Street, Honolulu, HI, 96818, USA.
  • Andrews SN; Department of Surgery, John A Burns School of Medicine, University of Hawai'i, 1356 Lusitana Street, Honolulu, HI, 96813, USA.
  • Nakasone CK; Department of Orthopedic Surgery, Straub Medical Center, 888 South King Street, Honolulu, HI, 96818, USA.
Arch Orthop Trauma Surg ; 143(7): 4371-4378, 2023 Jul.
Article en En | MEDLINE | ID: mdl-36326872
ABSTRACT

BACKGROUND:

Restoration of a neutral mechanical axis (MA) is important to the success of total knee arthroplasty (TKA). While known differences are present between Asians and Caucasians regarding native knee alignment, it is unknown whether such differences exist amongst Native Hawaiian/Other Pacific Islanders (NHPI) or if utilizing a fixed distal femoral cut of 6° can consistently achieve a neutral MA in these minority racial groups. This study examines the preoperative deformities presented by Asians, Caucasians, and NHPI, and the resulting knee alignment achieved following TKA when a fixed 6° distal femoral cut is targeted for all patients.

METHODS:

Preoperative and postoperative MA was measured from 835 Asian, 447 Caucasian, and 163 NHPI hip-to-ankle radiographs. All patients underwent TKA in which a standard distal femoral cut of 6° valgus was targeted for all patients. Data were evaluated as continuous variables and by groupings of varus (MA < - 3°), valgus (MA > 3°), and neutral (- 3° ≤ MA ≤ 3°) alignment.

RESULTS:

Preoperative deformity ranged from 38° varus to 29° valgus. The proportion of Asian and NHPI presenting with varus alignment prior to surgery was significantly greater than Caucasian patients in both males (Asians 80.6%; Caucasians 67.0%; NHPI 79.0%, p = 0.001) and females (Asians 66.1%; Caucasians 45.7%; NHPI 63.2%, p < 0.001). There was no difference in the proportion of patients (72-79%) achieving a neutral MA amongst all three racial groups.

CONCLUSION:

NHPI appear to have similar preoperative deformities to Asians with both groups having significantly more varus alignment than Caucasians. Despite a wide range of preoperative deformity, application of a fixed distal femoral cut of 6° valgus successfully established a neutral MA equally in the majority of patients across all three racial groups.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Osteoartritis de la Rodilla / Nativos de Hawái y Otras Islas del Pacífico Límite: Female / Humans / Male Idioma: En Año: 2023 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Osteoartritis de la Rodilla / Nativos de Hawái y Otras Islas del Pacífico Límite: Female / Humans / Male Idioma: En Año: 2023 Tipo del documento: Article