Anterior femoral cut in total knee arthroplasty: a classification proposal

Detalhes bibliográficos
Autor(a) principal: Medeiros, Filipe
Data de Publicação: 2019
Outros Autores: Duarte, António, Correia, Bruno, Carvalho, Maria, Vide, João, Fontes, Ana Paula, Sousa, João Paulo
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.1/18052
Resumo: Background: The cut of the anterior femur (CAF) sets the rotation of the femoral component, which could affect patellar tracking, and influence the clinical results on total knee arthroplasty (TKA). The aim of this study was to suggest a classification for anterior femoral cut in TKA. Methods: Images of anterior femoral cuts were aggregated in different shapes and defined a classification. Onehundred femoral image’s cuts were analysed by 5 orthopaedic surgeons, which classified them twice. To analyse inter and intra-observer agreement, the Fleiss Kappa test was used. Results: The study proposes the following CAF classification, type 1 (one peak) and type 2 (two peaks); subtypes 1 (a) a central base peak, 1 (b) a lateral base peak, 2 (a) two peaks where the smallest is in the lower half, and 2 (b) two peaks where the smallest is in the upper half. In our study, type 2 (a) was the most common type (54.5%), followed by type 1 (b). The analysis showed good intra- and inter-observer agreements (mean K of 0.774 and 0.627, respectively). The intra and inter-observer concordance was statistically significant in all the analyses. Conclusions: The CAF classification system for TKA is considered a reproducible classification. To our knowledge, there is no study describing a shape’s classification of this cut. A slight rotation of the femoral cutting guide could change the axial rotation and positioning of the femoral component. An undesirable cut could lead to different patellofemoral offset and could consequently cause anterior pain and instability.
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spelling Anterior femoral cut in total knee arthroplasty: a classification proposalTotal knee arthroplastyTotal knee replacementCut of anterior femurBackground: The cut of the anterior femur (CAF) sets the rotation of the femoral component, which could affect patellar tracking, and influence the clinical results on total knee arthroplasty (TKA). The aim of this study was to suggest a classification for anterior femoral cut in TKA. Methods: Images of anterior femoral cuts were aggregated in different shapes and defined a classification. Onehundred femoral image’s cuts were analysed by 5 orthopaedic surgeons, which classified them twice. To analyse inter and intra-observer agreement, the Fleiss Kappa test was used. Results: The study proposes the following CAF classification, type 1 (one peak) and type 2 (two peaks); subtypes 1 (a) a central base peak, 1 (b) a lateral base peak, 2 (a) two peaks where the smallest is in the lower half, and 2 (b) two peaks where the smallest is in the upper half. In our study, type 2 (a) was the most common type (54.5%), followed by type 1 (b). The analysis showed good intra- and inter-observer agreements (mean K of 0.774 and 0.627, respectively). The intra and inter-observer concordance was statistically significant in all the analyses. Conclusions: The CAF classification system for TKA is considered a reproducible classification. To our knowledge, there is no study describing a shape’s classification of this cut. A slight rotation of the femoral cutting guide could change the axial rotation and positioning of the femoral component. An undesirable cut could lead to different patellofemoral offset and could consequently cause anterior pain and instability.Medip AcademySapientiaMedeiros, FilipeDuarte, AntónioCorreia, BrunoCarvalho, MariaVide, JoãoFontes, Ana PaulaSousa, João Paulo2022-07-21T10:26:39Z2019-12-242022-07-20T16:54:38Z2019-12-24T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.1/18052eng2455-4510cv-prod-248544410.18203/issn.2455-4510.intjresorthop20195792info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-24T10:30:18Zoai:sapientia.ualg.pt:10400.1/18052Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:07:52.490113Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Anterior femoral cut in total knee arthroplasty: a classification proposal
title Anterior femoral cut in total knee arthroplasty: a classification proposal
spellingShingle Anterior femoral cut in total knee arthroplasty: a classification proposal
Medeiros, Filipe
Total knee arthroplasty
Total knee replacement
Cut of anterior femur
title_short Anterior femoral cut in total knee arthroplasty: a classification proposal
title_full Anterior femoral cut in total knee arthroplasty: a classification proposal
title_fullStr Anterior femoral cut in total knee arthroplasty: a classification proposal
title_full_unstemmed Anterior femoral cut in total knee arthroplasty: a classification proposal
title_sort Anterior femoral cut in total knee arthroplasty: a classification proposal
author Medeiros, Filipe
author_facet Medeiros, Filipe
Duarte, António
Correia, Bruno
Carvalho, Maria
Vide, João
Fontes, Ana Paula
Sousa, João Paulo
author_role author
author2 Duarte, António
Correia, Bruno
Carvalho, Maria
Vide, João
Fontes, Ana Paula
Sousa, João Paulo
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Sapientia
dc.contributor.author.fl_str_mv Medeiros, Filipe
Duarte, António
Correia, Bruno
Carvalho, Maria
Vide, João
Fontes, Ana Paula
Sousa, João Paulo
dc.subject.por.fl_str_mv Total knee arthroplasty
Total knee replacement
Cut of anterior femur
topic Total knee arthroplasty
Total knee replacement
Cut of anterior femur
description Background: The cut of the anterior femur (CAF) sets the rotation of the femoral component, which could affect patellar tracking, and influence the clinical results on total knee arthroplasty (TKA). The aim of this study was to suggest a classification for anterior femoral cut in TKA. Methods: Images of anterior femoral cuts were aggregated in different shapes and defined a classification. Onehundred femoral image’s cuts were analysed by 5 orthopaedic surgeons, which classified them twice. To analyse inter and intra-observer agreement, the Fleiss Kappa test was used. Results: The study proposes the following CAF classification, type 1 (one peak) and type 2 (two peaks); subtypes 1 (a) a central base peak, 1 (b) a lateral base peak, 2 (a) two peaks where the smallest is in the lower half, and 2 (b) two peaks where the smallest is in the upper half. In our study, type 2 (a) was the most common type (54.5%), followed by type 1 (b). The analysis showed good intra- and inter-observer agreements (mean K of 0.774 and 0.627, respectively). The intra and inter-observer concordance was statistically significant in all the analyses. Conclusions: The CAF classification system for TKA is considered a reproducible classification. To our knowledge, there is no study describing a shape’s classification of this cut. A slight rotation of the femoral cutting guide could change the axial rotation and positioning of the femoral component. An undesirable cut could lead to different patellofemoral offset and could consequently cause anterior pain and instability.
publishDate 2019
dc.date.none.fl_str_mv 2019-12-24
2019-12-24T00:00:00Z
2022-07-21T10:26:39Z
2022-07-20T16:54:38Z
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10.18203/issn.2455-4510.intjresorthop20195792
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