The comparison of three dimensional and two dimensional evaluation of varus/valgus stress X-rays following total knee arthroplasty

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). Postope...

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Main Authors: Hiroki Hijikata, Tomoharu Mochizuki, Keisuku Maeda, Osamu Tanifuji, Go Omori, Noriaki Yamamoto, Hiroyuki Kawashima
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-05741-z
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author Hiroki Hijikata
Tomoharu Mochizuki
Keisuku Maeda
Osamu Tanifuji
Go Omori
Noriaki Yamamoto
Hiroyuki Kawashima
author_facet Hiroki Hijikata
Tomoharu Mochizuki
Keisuku Maeda
Osamu Tanifuji
Go Omori
Noriaki Yamamoto
Hiroyuki Kawashima
author_sort Hiroki Hijikata
collection DOAJ
description 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.
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spelling doaj-art-664a637fa8674ddebf37376bd6df5cde2025-08-20T03:40:50ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-03-012011710.1186/s13018-025-05741-zThe comparison of three dimensional and two dimensional evaluation of varus/valgus stress X-rays following total knee arthroplastyHiroki Hijikata0Tomoharu Mochizuki1Keisuku Maeda2Osamu Tanifuji3Go Omori4Noriaki Yamamoto5Hiroyuki Kawashima6Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medicine and Dental ScienceDivision of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medicine and Dental ScienceDepartment of Orthopaedic Surgery, Niigata Rehabilitation HospitalDepartment of Orthopaedic Surgery, Saiseikai Niigata Kenoh Kikan HospitalDepartment of Health and Sports, Niigata University of Health and WelfareDepartment of Orthopaedic Surgery, Niigata Rehabilitation HospitalDivision of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medicine and Dental ScienceAbstract 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.https://doi.org/10.1186/s13018-025-05741-zRobotic total knee arthroplastyStress x-rayComparison between 3D/2D evaluation
spellingShingle Hiroki Hijikata
Tomoharu Mochizuki
Keisuku Maeda
Osamu Tanifuji
Go Omori
Noriaki Yamamoto
Hiroyuki Kawashima
The comparison of three dimensional and two dimensional evaluation of varus/valgus stress X-rays following total knee arthroplasty
Journal of Orthopaedic Surgery and Research
Robotic total knee arthroplasty
Stress x-ray
Comparison between 3D/2D evaluation
title The comparison of three dimensional and two dimensional evaluation of varus/valgus stress X-rays following total knee arthroplasty
title_full The comparison of three dimensional and two dimensional evaluation of varus/valgus stress X-rays following total knee arthroplasty
title_fullStr The comparison of three dimensional and two dimensional evaluation of varus/valgus stress X-rays following total knee arthroplasty
title_full_unstemmed The comparison of three dimensional and two dimensional evaluation of varus/valgus stress X-rays following total knee arthroplasty
title_short The comparison of three dimensional and two dimensional evaluation of varus/valgus stress X-rays following total knee arthroplasty
title_sort comparison of three dimensional and two dimensional evaluation of varus valgus stress x rays following total knee arthroplasty
topic Robotic total knee arthroplasty
Stress x-ray
Comparison between 3D/2D evaluation
url https://doi.org/10.1186/s13018-025-05741-z
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