Three-dimensional models demonstrate differences in correction depending on femoral derotational osteotomy site and may enhance the planning and precision in femoral derotational osteotomy - An observational study in eight femora and two surgeons
Chiappe, Caterina (Universitat Autònoma de Barcelona)
Roselló Añón, Alejandro (Hospital Arnau de Vilanova (València))
Sanchis-Alfonso, Vicente (Hospital Arnau de Vilanova (València))
Monllau García, Joan Carles (Universitat Autònoma de Barcelona. Departament de Medicina)
Domenech Fernández, Julio (Clínica Universidad de Navarra)

Date:	2025
Abstract:	Background: Increased femoral anteversion (FAV) is crucial in the genesis of anterior knee pain (AKP) and a femoral derotational osteotomy (FDO) has demonstrated good clinical results. It remains unclear at what level of the femur the osteotomy should be performed. Resulting degrees of FAV measured by Murphy's method do not always correspond to the degrees that had been planned after an FDO. The hypothesis of this study is that the femur rotation axis and the osteotomy rotation axis do not coincide. Three-dimensional (3D) technology is used to objectify the discrepancy between these two axes and to find solutions so that the two axes can coincide. The objective is to demonstrate the reliability and reproducibility of the 3D technique for osteotomy adjustment through an intraobserver and interobserver study. Methods: Images of eight computed tomography scans of the femur, corresponding to seven patients with a diagnosis of AKP and increased FAV, were selected. Two surgeons performed the FAV measurement and simulation of FDO on 3D biomodels. The femoral osteotomies were defined at three levels, at 10°, 20°, 30°. To determine interobserver agreement, measurements were performed independently by two surgeons. To evaluate intraobserver differences each surgeon repeated all measurements after 15 days. Results: Interobserver and intraobserver agreement: intraclass correlation coefficient 0. 930 (95% confidence interval (CI) 0. 799-0. 975) and 0. 986 (95% CI 0. 959-0. 995). Significant differences between the resulting values were observed when the osteotomy was performed at the intertrochanteric level. Conclusions: The misalignment of the axes results in hypocorrection when the osteotomy is intertrochanteric. This phenomenon is not observed when the osteotomy is diaphyseal or supracondylar.
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Language:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Subject:	3D technology ; Anterior knee pain ; Femoral anteversion ; Femoral osteotomy
Published in:	Knee, Vol. 52 (January 2025) , p. 131-138, ISSN 1873-5800

DOI: 10.1016/j.knee.2024.10.023

Available from: 2026-01-31 Postprint

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