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Rendimiento diagnóstico de la radiografía convencional simple de rodilla en la identificación de éxito de reemplazo total de rodilla
dc.rights.license | Atribución-NoComercial-SinDerivadas 4.0 Internacional |
dc.contributor.advisor | Ortiz Morales, Jorge Rolando |
dc.contributor.author | González Gil, Juliana |
dc.date.accessioned | 2021-02-01T17:49:16Z |
dc.date.available | 2021-02-01T17:49:16Z |
dc.date.issued | 2020-07-01 |
dc.identifier.citation | González Gil, J. (2020). Rendimiento diagnóstico de la radiografía convencional simple de rodilla en la identificación de éxito de reemplazo total de rodilla [Tesis de especialidad, Universidad Nacional de Colombia]. Repositorio Institucional. |
dc.identifier.uri | https://repositorio.unal.edu.co/handle/unal/79014 |
dc.description.abstract | Background: Total knee arthroplasty is one of the most common orthopedic procedures. The coronal alignment of the lower limb is important for planning and assessing outcomes and should be restored. The aim of this study was to determine whether standard anteroposterior knee radiographs adequately assess lower limb alignment respect to full limb radiograph. Methods: There were obtained pre-operative and postoperative knee radiograph and weight-bearing hip-to-ankle radiograph of one hundred thirty-two knees. We analyzed the measurements on coronal plane to determinate diagnostic performance in terms of sensitivity, specificity, predictive values and likelihood ratios of these in the standard x-ray. Results: Tibiofemoral angle of preoperative and postoperative radiographs shows best performance respect the other measurements in mechanical axis assessment with sensitivity of 51.81% to 86.96% and specificity of 33.33% to 50% which increase when another abnormal or positive angle is added. Full limb radiograph analysis shows that standard knee radiograph tibiofemoral angle also has the higher sensitivity and specificity of 36.84% to 88% and of 63.64 to 100% respectively in comparison with anatomic tibiofemoral angle. Conclusions: Global trend respect to anteroposterior knee radiograph performance shows higher sensitivity in preoperative measurements but higher specificity in postoperative measurements, therefore proving that standard knee radiograph is useful for inferior limb axis assessment mainly when are considered as a positive or negative test combination of two abnormal vs normal angles (α angle plus tibiofemoral angle) or three altered vs normal angles respectively. |
dc.description.abstract | Introducción: El reemplazo total de rodilla es uno de los procedimientos quirúrgicos más frecuentes en cirugía ortopédica, el alineamiento de la extremidad inferior en el plano coronal debe tenerse en cuenta para el planeamiento preoperatorio y debe ser restaurado durante la cirugía. Este estudio evalúa el rendimiento diagnóstico de la radiografía simple en comparación a la ortorradiografía para determinar el alineamiento de la extremidad. Métodos: Se analizaron secuencialmente radiografías y ortorradiografías pre y posoperatorias de 132 rodillas, se realizaron mediciones en plano coronal de los dos estudios y se determinaron sensibilidad y especificidad de éstas en la radiografía simple. Resultados: El ángulo femorotibial en la radiografía simple pre o posoperatoria es el que tiene mayor rendimiento con sensibilidad entre 51.81% al 86.96% y especificidad 33.33% al 50% al comparar con el eje mecánico y que aumenta a medida que se combinan medidas del plano coronal anormales. Con respecto al ángulo femorotibial de la ortorradiografía el ángulo femorotibial en la radiografía simple pre o posoperatoria también es el que tiene mayor rendimiento con sensibilidad entre 36.84% al 88% y especificidad entre 63.64% al 100%. Conclusiones: La tendencia global en relación al rendimiento de la radiografía muestra mayor sensibilidad en las mediciones preoperatorias y mayor especificidad en las mediciones postoperatorias evidenciando ser una prueba útil en la determinación de la desviación del eje mecánico principalmente cuando se considera como prueba positiva o negativa la combinación de dos medidas anormales vs normales (ángulo α mas femorotibial) o de los tres ángulos alterados o normales respectivamente. |
dc.format.extent | 47 |
dc.format.mimetype | application/pdf |
dc.language.iso | spa |
dc.rights | Derechos reservados - Universidad Nacional de Colombia |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
dc.subject.ddc | 617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología |
dc.title | Rendimiento diagnóstico de la radiografía convencional simple de rodilla en la identificación de éxito de reemplazo total de rodilla |
dc.type | Otro |
dc.rights.spa | Acceso abierto |
dc.type.driver | info:eu-repo/semantics/other |
dc.type.version | info:eu-repo/semantics/acceptedVersion |
dc.publisher.program | Bogotá - Medicina - Especialidad en Ortopedia y Traumatología |
dc.description.degreelevel | Especialidades Médicas |
dc.publisher.branch | Universidad Nacional de Colombia - Sede Bogotá |
dc.relation.references | Lee SC, Gondalia V, Hwang BY. Is end-stage lateral osteoarthritic knee always valgus? Mechanical alignment analysis and radiographic severity assessment. J Orthopaed Traumatol. 2015; 17:35-40. https://doi:10.1007/s10195-015-0356-9 |
dc.relation.references | Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD. The rol of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA. 2001 286: 188-95. https://doi: 10.1001/jama.286.2.188. |
dc.relation.references | NiemeläInen MJ, Mäkelä KT, Robertsson O. Different incidences of knee arthroplasty in the Nordic countries. Acta Orthop. 2017, 88:173-178. https://doi: 10.1080/17453674.2016.1275200. |
dc.relation.references | Neil MJ, Atupan JB, Panti JP, Massera RAJ. Evaluation of lower limb axial alignment using digital radiography stitched films in pre-operative planning for total knee replacement. J Orthop. 2016, 13: 285-289. https://doi.org/10.1016/j.jor.2016.06.013. |
dc.relation.references | Paley D. Normal Lower Limb Alignment and Joint Orientation. En: Herzenberg J.E, editor. Principles of Deformity correction. 1st ed. Nueva York. 2002. P. 1-17. |
dc.relation.references | Ewald FC. The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res. 1989; 248:9–12. https://doi:10.1302/0301-620X.94B10. |
dc.relation.references | Meneghini RM, Mont MA, Backstein DB. Development of a Modern Knee Society Radiographic Evaluation System and Methodology for Total Knee Arthroplasty. J Arthroplasty. 2015. 30: 2311-2314. http://dx.doi.org/10.1016/j.arth.2015.05.049 |
dc.relation.references | Ritter MA, Faris PM, Keating EM. Postoperative alignment of total knee replacement. Its effect on survival. Clin Orthop Relat Res. 1994. 299: 153-156. |
dc.relation.references | Park JK, Seon JK, Cho KJ. Is Immediate Postoperative Mechanical Axis Associated with the Revision Rate of Primary Total Knee Arthroplasty? A 10-Year Follow-up Study. Clin Orthop Surg. 2018. 10: 167-173. https://doi.org/10.4055/cios.2018.10.2.167 |
dc.relation.references | Sarmah S.S, Patel S, Hossain. The radiological assessment of total and unicompartmental Knee replacements. J Bone Joint Surg Br 2012. 94 (10):1321-9. doi: 10.1302/0301-620X.94B10.29411. |
dc.relation.references | Kumar N, Yadav Ch, Raj R, Anand S. How to Interpret Posoperative X-rays after total knee Arthroplasty. Orthopaedic Surgery 2014. 6: 179-186. doi: 10.1111/os.12123. |
dc.relation.references | Bowman A, Shunmugan M, Watts AR, Bramwell DC, Wilson C, Krishnan J. Inter-observer and intra-observer realiability of mechanical axis alignment before and after total knee arthroplasty using long leg radiographs. The Knee 2016. 23: 203-208. doi: 10.1016/j.knee.2015.11.013. |
dc.relation.references | Specogna AV, Birminghan TB, Hunt MA, Jones IC, Jenkyn TR, Fowler PJ, Giffin JR. Radiographic measurements of knee alignment in patients with varus gonarthrosis: effect of weightbearing status and associations with dynamic join load. Am J Sports Med 2007. 35: 65-70. doi: 10.1177/0363546506293024. |
dc.relation.references | Babazadeh Sina y cols. The long leg radiograph is a reliable method of assessing alignment when compared to computer-assisted navigation and computer tomography. The Knee 2013 20: 242-249. doi: 10.1016/j.knee.2012.07.009. |
dc.relation.references | Chung BJ, Dileep I, Chan CB, Kang YG, Park YB, Kim TK. Novel approach to reducing discrepancies in radiographic and navigational limb alignments in computer-assisted TKR. Orthopedics 2010. 33: 62-67. doi: 10.3928/01477447-20100510-56. |
dc.relation.references | Siu D, Cooke TD, Broekhoven ld, Lam M, Fisher B, Saunders G, Challis TW. A standardized technique for lower limb radiography. Practice, applications, and error analysis. Invest Radiol 1991. 26: 71-77. doi: 10.1097/00004424-199101000-00013. |
dc.relation.references | Yau WP, Leung A, Liu KG, Yan ch, Wong L, Chiu KY. Interobserver and intra-observer errors in obtaining visually selected anatomical landmarks during registration process in non-image-based navigation-assisted total knee arthroplasty. J Arthroplasty 2007. 22: 1150-1161. doi: 10.1016/j.arth.2006.10.010. |
dc.relation.references | Yau WP, Leung A, Chiu KY, Tang WM, Ng TP. Intraobserver errors in obtaining visually selected anatomic landmarks during registration process in non-image-based navigation-assisted total knee arthroplasty: a cadaveric experiment. J Arthroplasty 2005. 20: 591-601. doi: 10.1016/j.arth.2005.02.011. |
dc.relation.references | Pitto RP, Graydon AJ, Bradley L, Malak SF, Walker CG, Anderson IA. Accuracy of a computer-assisted navigation system for total knee replacement. J Bone Join Surg Br 2006. 88: 601-605. doi: 10.1302/0301-620X.88B5.17431 |
dc.relation.references | Sabharwal S, Zhao C. Assessment of lower limb alignment: supine fluoroscopy compared with a standing full-length radiograph. J Bone Joint Surg Am 2008. 90: 43-51. doi: 10.2106/JBJS.F.01514. |
dc.relation.references | Choi WC, Lee S, Hwan An J, Kim D, Seong SC, Chul Lee M. Plain Radiograph Fails to Reflext the Alignment and Advantages of Navigation in Total Knee Arthroplasty. J Arthroplasty 2011. 26: 756-64. doi: 10.1016/j.arth.2010.07.020. |
dc.relation.references | Manfrin FG, Maestu R. Artroplastia total de rodilla con asistencia de navegación. Nuestra experiencia. Rev. Asoc. Argent.Ortop. Traumatol 2009. 74: 341-346 |
dc.relation.references | Mclelland J, Webster KE, Ramteke AA, Feller JA. Total Knee arthroplasty with computer-assisted navigation more closely replicates normal knee biomechanics than conventional surgery. The knee 2017. 24: 651-656. doi: 10.1016/j.knee.2016.12.009 |
dc.relation.references | Aravind SD, Dramis A, Knedoff D, Board T. Critical review of the current practice for computer-assisted navigation in total knee replacement surgery: cost-effectiveness and clinical outcome. Curr Rev Musculoskelet Med. 2011. 4: 11-15. doi: 10.1007/s12178-011-9071-1. |
dc.relation.references | Yaffe M, Chan P, Goyal N, Luo M, Cayo M, Stulberg SD. Computer-assisted Versus Manual TKR: No Difference in clinical or Functional Outcomes at 5-year Follow-up. Orthopedics 2013. 36: 627-632. doi: 10.3928/01477447-20130426-26. |
dc.relation.references | Hinman RS, May RL, Crossley KM. Is There an Alternative to the Full-Leg Radiograph for Determining Knee Joint Alignment in Osteoarthritis? Arthritis Rheum. 2006. 55: 306-313. https://doi 10.1002/art.2183. |
dc.relation.references | Issa SN, Dunlop D, Chang A. Full-Limb and Knee Radiography Assessments of Varus-Valgus Alignment and Their Relationship to Osteoarthritis Disease Features by Magnetic Resonance Imaging. Arthritis Rheum. 2007. 57: 398-406. https://doi: 10.1002/art.22618. |
dc.relation.references | Skytta E.T, Lohman M, Talleoth K. Comparison of standard anteroposterior knee and hip-to-ankle radiographs in determining the lower limb and implant alignment after total knee arthroplasty. Scan J Surg. 2009. 98: 250-253. https://10.1177/145749690909800411. |
dc.relation.references | Colebatch AN, Hart D.J, Zhai G. Effective measurements of knee alignment using AP knee radiographs. The knee. 2009. 16: 42-45. https://doi:10.1016/j.knee.2008.07.007 |
dc.relation.references | Abdel MP, Ollivier M, Parratte S. Effect of Postoperative Mechanical Axis Alignment on Survival and Functional Outcomes of Modern Total Knee Arthroplasties with Cement. J Bone Joint Surg Am. 2018. 100: 472-8. http://dx.doi.org/10.2106/JBJS.16.01587 |
dc.relation.references | Hart D, Wall BF. Radiation exposure of the UK population from medical and dental X-ray examination. Document NRPB-R289. Chilton, UK: National Radiological Protection Board: 2002 |
dc.rights.accessrights | info:eu-repo/semantics/openAccess |
dc.subject.proposal | Limb alingment |
dc.subject.proposal | Alineamiento |
dc.subject.proposal | Specificity |
dc.subject.proposal | Especificidad |
dc.subject.proposal | Valoración radiográfica |
dc.subject.proposal | Sensitivity |
dc.subject.proposal | Full limb radiograph |
dc.subject.proposal | Sensibilidad |
dc.subject.proposal | Ortorradiografía |
dc.subject.proposal | Radiographic assessment |
dc.type.coar | http://purl.org/coar/resource_type/c_1843 |
dc.type.coarversion | http://purl.org/coar/version/c_ab4af688f83e57aa |
dc.type.content | Text |
oaire.accessrights | http://purl.org/coar/access_right/c_abf2 |
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