X-ray of knee prosthesis - Revision history

Mikael Häggström: /* Reporting */ +Example

2019-07-24T15:04:50Z

Reporting: +Example

Mikael Häggström: /* Reporting */ Emphasis

2019-07-24T15:01:25Z

Reporting: Emphasis

Mikael Häggström: /* Follow-up */ +Zones

2019-07-24T14:56:52Z

Follow-up: +Zones

Mikael Häggström: /* Report */ Opposed

2019-07-02T10:38:53Z

Report: Opposed

Mikael Häggström: /* Report */ Wording

2019-07-02T10:37:50Z

Report: Wording

Mikael Häggström: /* Post-operative evaluation */ Cleanup

2019-07-02T10:31:08Z

Post-operative evaluation: Cleanup

Mikael Häggström: /* Report */ ventral

2019-07-02T10:30:46Z

Report: ventral

Mikael Häggström: /* Post-operative evaluation */ Specific images

2019-06-25T10:43:04Z

Post-operative evaluation: Specific images

Mikael Häggström: /* Post-operative evaluation */ +Anterior femoral notching

2019-05-28T09:28:30Z

Post-operative evaluation: +Anterior femoral notching

Mikael Häggström: /* Post-operative evaluation */ Reporting

2019-05-18T09:19:05Z

Post-operative evaluation: Reporting

@@ Line 46: / Line 46: @@
 In Swedish healthcare<ref>{{NU Hospital Group}}, Oct 2018</ref>, an example report of a normal case may be:
 *''No changes since previous images on <date>.''
-For localization of focal changes using zones, specify what zone system is used, since there are several.
+For localization of focal changes using zones, specify what zone system is used, since there are several. For example:
 {{Reporting}}
 {{Bottom}}

@@ Line 46: / Line 46: @@
 In Swedish healthcare<ref>{{NU Hospital Group}}, Oct 2018</ref>, an example report of a normal case may be:
 *''No changes since previous images on <date>.''
 {{Reporting}}
 {{Bottom}}

@@ Line 25: / Line 25: @@
 ===Radiolucent lines===
-Radiolucent lines may indicate loosening of the implant. A radiolucent line thinner than than 2 mm can be tolerated at the cement-bone interface (for cemented implants) or implant-bone interface (for cementless implants) if it remains stable and appears within the first 6 months (cemented implants) or the first 2 years (cementless implants) after surgery.<ref name="Cyteval2016">{{cite journal|last1=Cyteval|first1=C.|title=Imaging of knee implants and related complications|journal=Diagnostic and Interventional Imaging|volume=97|issue=7-8|year=2016|pages=809–821|issn=22115684|doi=10.1016/j.diii.2016.02.015}}</ref>
+[[File:Knee prosthesis zones by Knee Society 2015, lateral view.jpg|thumb|150px|KS (Knee Society) zones, for localizing radiolucent zones or other focal changes.<ref name="MeneghiniMont2015">{{cite journal|last1=Meneghini|first1=R. Michael|last2=Mont|first2=Michael A.|last3=Backstein|first3=David B.|last4=Bourne|first4=Robert B.|last5=Dennis|first5=Doug A.|last6=Scuderi|first6=Giles R.|title=Development of a Modern Knee Society Radiographic Evaluation System and Methodology for Total Knee Arthroplasty|journal=The Journal of Arthroplasty|volume=30|issue=12|year=2015|pages=2311–2314|issn=08835403|doi=10.1016/j.arth.2015.05.049}}</ref>]]
 ===Displacement===

@@ Line 18: / Line 18: @@
 Also, unless you know the referring physician is familiar with the same angle terminology, preferably report any deviating angles as varus/valgus deviation or ventral/dorsal angulation, such as:
 *An abnormally increased valgus angulation of __° of the femur component in relation to femoral diaphysis.
-*An abnormally increased dorsal angulation of __° of the tibial diaphysis in relation to the tibial component.
+*A abnormal ventral angulation of __° of the tibial diaphysis in relation to the tibial component.
 {{Reporting}}

@@ Line 16: / Line 16: @@
 *''Postoperative images of knee implant in unremarkable position.''
-Also, unless you know the referring physician is familiar with the same angle terminology, preferably report deviating angles as varus/valgus deviation or ventral/dorsal angulation of either:
+Also, unless you know the referring physician is familiar with the same angle terminology, preferably report any deviating angles as varus/valgus deviation or ventral/dorsal angulation, such as:
-*The femur component in relation to femoral diaphysis
+*An abnormally increased valgus angulation of __° of the femur component in relation to femoral diaphysis.
-*The tibial diaphysis in relation to the tibial component.
+*An abnormally increased dorsal angulation of __° of the tibial diaphysis in relation to the tibial component.
 {{Reporting}}

@@ Line 4: / Line 4: @@
 }}
 ==Post-operative evaluation==
-File:X-ray of knee prosthesis with overhang, annotated.jpg|thumb|150px|Overhang (arrow) does not seem to have any detrimental effect.<ref>{{cite journal|title=The Impact Of Tibial Component Overhang On Outcome Scores And Pain In Total Knee Replacement|date=2018-02-21|author=S.G.F. Abram, A.G Marsh, F. Nicol, A.S. Brydone, A. Mohammed, S.J. Spencer|journal=Orthopaedic Proceedings}}</ref> It is therefore not necessary to measure or report.]]
+[[File:X-ray of knee prosthesis with overhang, annotated.jpg|thumb|150px|Overhang (arrow) does not seem to have any detrimental effect.<ref>{{cite journal|title=The Impact Of Tibial Component Overhang On Outcome Scores And Pain In Total Knee Replacement|date=2018-02-21|author=S.G.F. Abram, A.G Marsh, F. Nicol, A.S. Brydone, A. Mohammed, S.J. Spencer|journal=Orthopaedic Proceedings}}</ref> It is therefore not necessary to measure or report.]]
 Knee replacement is evaluated by the following measures:
 <gallery mode=packed heights=380>
 File:X-ray of HKA angle with knee prosthesis.jpg|'''HKA''': Hip-knee-ankle angle, which is ideally between 3° [[genu varum|varum]] to 3° [[Genu valgum|valgum]] from a [[right angle]].<ref name=Inui2013>{{cite journal|last1=Inui|first1=Hiroshi|last2=Taketomi|first2=Shuji|last3=Nakamura|first3=Kensuke|last4=Takei|first4=Seira|last5=Takeda|first5=Hideki|last6=Tanaka|first6=Sakae|last7=Nakagawa|first7=Takumi|title=Influence of navigation system updates on total knee arthroplasty|journal=Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology|volume=5|issue=1|pages=10|year=2013|issn=1758-2555|doi=10.1186/2052-1847-5-10|pmid=23638774|pmc=3653716}} [https://creativecommons.org/licenses/by/2.0 (CC-BY-2.0)]</ref>
 File:Postoperative X-ray of normal knee prosthesis, anteroposterior view, annotated.jpg|- '''FFC''': frontal femoral component angle. It is typically regarded as optimal when being 2–7° in valgus.<ref name="GromovKorchi2014">{{cite journal|last1=Gromov|first1=Kirill|last2=Korchi|first2=Mounim|last3=Thomsen|first3=Morten G|last4=Husted|first4=Henrik|last5=Troelsen|first5=Anders|title=What is the optimal alignment of the tibial and femoral components in knee arthroplasty?|journal=Acta Orthopaedica|volume=85|issue=5|year=2014|pages=480–487|issn=1745-3674|doi=10.3109/17453674.2014.940573|pmid=25036719|pmc=4164865}}</ref><br>- '''FTC''': frontal tibial component angle, which is regarded as optimal when being at a [[right angle]]. A varus position of more than 3° has generally been found to increase the failure rate of the prosthesis.<ref name="GromovKorchi2014"/>
-File:Postoperative X-ray of normal knee prosthesis, lateral view, annotated.jpg|- '''Anterior femoral notching''' (the femoral component causing reduced thickness of the distal femur anteriorly), seems to cause an increased risk of fractures when exceeding about 3 mm.<ref name="LeeWang2015">{{cite journal|last1=Lee|first1=Ju Hong|last2=Wang|first2=Seong-Il|title=Risk of Anterior Femoral Notching in Navigated Total Knee Arthroplasty|journal=Clinics in Orthopedic Surgery|volume=7|issue=2|year=2015|pages=217|issn=2005-291X|doi=10.4055/cios.2015.7.2.217}}</ref><br>- '''LTC''': lateral (or sagittal) tibial component angle, which is ideally positioned so that the tibia is 0–7° flexed compared to at a right angle with the tibial plate.<ref name="GromovKorchi2014"/>]]
+File:Postoperative X-ray of normal knee prosthesis, lateral view, annotated.jpg|- '''Anterior femoral notching''' (the femoral component causing reduced thickness of the distal femur anteriorly), seems to cause an increased risk of fractures when exceeding about 3 mm.<ref name="LeeWang2015">{{cite journal|last1=Lee|first1=Ju Hong|last2=Wang|first2=Seong-Il|title=Risk of Anterior Femoral Notching in Navigated Total Knee Arthroplasty|journal=Clinics in Orthopedic Surgery|volume=7|issue=2|year=2015|pages=217|issn=2005-291X|doi=10.4055/cios.2015.7.2.217}}</ref><br>- '''LTC''': lateral (or sagittal) tibial component angle, which is ideally positioned so that the tibia is 0–7° flexed compared to at a right angle with the tibial plate.<ref name="GromovKorchi2014"/>
 </gallery>

@@ Line 10: / Line 10: @@
 *'''FTC''': frontal tibial component angle, which is regarded as optimal when being at a [[right angle]]. A varus position of more than 3° has generally been found to increase the failure rate of the prosthesis.<ref name="GromovKorchi2014"/>
 *'''LTC''': lateral (or sagittal) tibial component angle, which is ideally positioned so that the tibia is 0–7° flexed compared to at a right angle with the tibial plate.<ref name="GromovKorchi2014"/>
 '''LFC''' is the lateral (or sagittal) femoral component angle,<ref name=Inui2013/> but its use is not necessary as long as there are no established clinically relevant reference ranges for it.