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Calin DRAGOSLOVEANU

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Articles signed on MÆDICA, JCM:

Radiographic Evaluation of Alignment Following Total Knee Arthroplasty – a Systematic Review. Part II

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MÆDICA - a Journal of Clinical Medicine | Vol. 13, nr. 2, 2018
CNCSIS - CMR - B+ OBBCSSR

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Radiographic Evaluation of Alignment Following Total Knee Arthroplasty – a Systematic Review. Part II

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ABSTRACT

The aim of this second part is to review the existing described methods for measuring postoperative total knee arthroplasty (TKA) alignment in sagital and axial plane as well as the existing literature regarding the axial plane evaluation with the use of computer tomography. Given that the most frequent mistakes when positioning the total knee arthroplasty components are made in the axial plane, it is necessary to know what are the limits of radiographic evaluation, for which CT scan is the most valuable tool in assessing the rotation of the components.
Keywords: TKA alignment, sagital plane, axial plane, rotational analysis, CT evaluation.

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Radiographic evaluation of alignment following TKA, a systematic review

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MÆDICA - a Journal of Clinical Medicine | Vol. 12, nr. 3, 2017
CNCSIS - CMR - B+ OBBCSSR

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Radiographic evaluation of alignment following TKA, a systematic review

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ABSTRACT

Postoperative assessment is of paramount importance in primary total knee arthroplasty. A thorough postoperative analysis helps the surgeon anticipate any postoperative potential issues and correlate the preoperative planning with the postoperative result, and provides better understanding of the importance of surgical principles of primary total knee arthroplasty. In addition, postoperative analysis helps the surgeon understand surgical errors and improve future outcomes. Standard radiographs, with a known magnification, should be obtained for postoperative total knee arthroplasty evaluation. Although imaging evaluation of knee arthroplasty is usually limited to conventional radiographs, examples of the utility of computed tomography are also illustrated, and suggested imaging strategies discussed.
Keywords: total knee arthroplasty, radiographic evaluation, TKA alignment, long-leg radiographs, Roentgenographic evaluation

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The Effect of High Tibial Osteotomy on the Posterior Tibial Slope

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MÆDICA - a Journal of Clinical Medicine | Vol. 9, nr. 2, 2014

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The Effect of High Tibial Osteotomy on the Posterior Tibial Slope

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ABSTRACT

Introduction: High tibial osteotomy remains a useful procedure for delaying total knee arthroplasty for young patients with unicompartimental medial osteoarthritis of the knee. The tibial posterior slope is essential for both ligament function and knee kinematics. Even though many articles were published in the literature, the long term influence of open wedge high tibial osteotomy on the posterior slope of the tibial plateau remains unknown.

Objective: We assessed the relationship among the degree of correction, the surgical technique, the postoperative modification of tibial slope, knee flexion and Knee score at the two years.

Material and methods: We used for evaluation a calibrated x-rays with correction factor. All the measures were done with Cedara I-View 6.3.2 application. All 47 patients were operated in our hospital between 2008-2011, with the same technique, open wedge high tibial osteotomy with an acrylic cement wedge. All patients postponed weight bearing for 6 weeks.

Results: We found that there is no statistical significance (p=0.2) between the preoperative varus and the after surgery tibial slope, but the resulting posterior inclination after surgery influences the tibial posterior slope at 2 years (p<=0.005).The degree of correction has a strong influence over the increase or decrease of tibial posterior slope(p<0.005). An increase in tibial slope increases the knee flexion by 1.45° for every degree of inclination (p<0.05). Functional results are not influenced by small modifications in tibial inclination (p>0.05).

Conclusion: From this findings we may conclude that the most important factors that changes the posterior inclination of the tibia surface are the height of the cement wedge and the surgical technique, by placing the acrylic cement wedge more anteriorly. We have found that the vast majority of our high tibial osteotomies are in fact “flexion” osteotomies. At the 2 years control we have found a slight increase in tibial slope angle (average 1.77°) and knee flexion (average 2.56°) with no functional response. This is a case series study with level of evidence IV.

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