{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T15:28:15Z","timestamp":1781882895369,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,4,24]],"date-time":"2014-04-24T00:00:00Z","timestamp":1398297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,4,24]],"date-time":"2014-04-24T00:00:00Z","timestamp":1398297600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004085","name":"Ministry of Education, Science and Technology","doi-asserted-by":"publisher","award":["2012\u20100000479"],"award-info":[{"award-number":["2012\u20100000479"]}],"id":[{"id":"10.13039\/501100004085","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of this study was to determine (1) variations in the shape of the proximal, middle, and distal femur in a series of Korean patients who had undergone total knee arthroplasty (TKA), (2) the preoperative relationship between these three parameters and the distal valgus cutting angle referenced off the femoral intramedullary guide, and (3) whether there was any relationship between femoral bowing and variations in the shape of the proximal or distal femur in the coronal plane.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The preoperative long\u2010standing anteroposterior radiographs of 316 consecutive osteoarthritis patients who underwent primary TKA from 2009 to 2011 were examined. The femoral neck shaft angle, the femoral shaft bowing angle, and the mechanical lateral distal femoral angle were measured to assess the shape of the proximal, middle, and distal femur, respectively. The valgus cutting angle of the femur was defined as the angle between the distal anatomical and mechanical axes of the femur.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study population showed large variations in femoral shape. The mean femoral intramedullary guide angle was 6.5\u00b0 \u00b1 1.3\u00b0 (range: 4\u00b0\u201313\u00b0). The femoral shaft bowing angle was the factor that showed the strongest correlation with this angle (<jats:italic>P<\/jats:italic> &lt; 0.001). The mechanical lateral distal femoral angle showed only a weak correlation (<jats:italic>P<\/jats:italic> = 0.001), and the femoral neck shaft angle showed no correlation (n.s.). The femoral shaft bowing angle showed a weak correlation with the mechanical lateral distal femoral angle (<jats:italic>P<\/jats:italic> = 0.001), but was not significantly correlated with the femoral neck shaft angle (n.s.). Apparent femoral bowing (&gt;3\u00b0 of lateral or medial bowing) was found in 42 (13.3 %) of cases (37 cases of lateral bowing and five of medial bowing). Cases with lateral apparent femoral bowing &gt;3\u00b0 had a distal cutting angle of 8.6\u00b0 \u00b1 2.2\u00b0 relative to the femoral intramedullary guide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The femoral intramedullary guide angle was mainly influenced by femoral shaft bowing among femoral deformities in the coronal plane. Therefore, to increase the accuracy of distal femoral cut during TKA, it is necessary to confirm femoral deformities and to measure the femoral intramedullary guide angle preoperatively from coronal radiographs covering the whole femur.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-014-3006-5","type":"journal-article","created":{"date-parts":[[2014,4,23]],"date-time":"2014-04-23T11:25:15Z","timestamp":1398252315000},"page":"1936-1942","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Femoral shaft bowing in the coronal plane has more significant effect on the coronal alignment of TKA than proximal or distal variations of femoral shape"],"prefix":"10.1002","volume":"23","author":[{"given":"Jong\u2010Min","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Kosin Gospel Hospital College of Medicine Kosin University 34, Amnam\u2010dong, Seo\u2010gu 602\u2010702 Busan South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo\u2010Heon","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Asan Medical Center College of Medicine Ulsan University 388\u20101, Pungnap\u20102\u2010dong, Songpa\u2010gu 138\u2010736 Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong\u2010Min","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Asan Medical Center College of Medicine Ulsan University 388\u20101, Pungnap\u20102\u2010dong, Songpa\u2010gu 138\u2010736 Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bum\u2010Sik","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Incheon St. Mary's Hospital College of Medicine Catholic University Bupyeong 6\u2010dong, Bupyeong\u2010gu 403\u2010720 Inchon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong\u2010Eun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Asan Medical Center College of Medicine Ulsan University 388\u20101, Pungnap\u20102\u2010dong, Songpa\u2010gu 138\u2010736 Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung\u2010Ah","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering College of Medicine Chungbuk National University Gaesin\u2010dong, Heungdeok\u2010gu 361\u2010763 Cheongju\u2010si Chungcheongbuk\u2010do South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong\u2010Il","family":"Bin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Asan Medical Center College of Medicine Ulsan University 388\u20101, Pungnap\u20102\u2010dong, Songpa\u2010gu 138\u2010736 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