{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:25:20Z","timestamp":1791253520526,"version":"4.1.0"},"reference-count":14,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,5,20]],"date-time":"2014-05-20T00:00:00Z","timestamp":1400544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,5,20]],"date-time":"2014-05-20T00:00:00Z","timestamp":1400544000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Kinematically aligned total knee arthroplasty (TKA) positions the femoral component at the natural angle and level of the distal (0\u00b0) and posterior (90\u00b0) joint line. This technique applies referencing guides at 0\u00b0 and 90\u00b0 that are adjusted to compensate for wear and kerf and perform resections equal in thickness to the femoral component. Knowing whether femoral bone and cartilage wear is predictable would assist in establishing general guidelines for adjusting the resection level of these two referencing guides. This study tests the hypothesis that femoral bone and cartilage wear is predictable at 0\u00b0 and 90\u00b0 in the varus and valgus osteoarthritic knee treated with TKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study consists of 205 patients and 208\u00a0knees with Kellgren\u2013Lawrence Grade 3 or 4 osteoarthritis and treated with a TKA. Each knee had a narrow slice (2\u00a0mm) preoperative 1.5 tesla magnetic resonance image in the sagittal plane. Femoral bone and cartilage wear at 0\u00b0 and 90\u00b0 was computed from best\u2010fit circles superimposed on the peripheral boundary of the subchondral bone on the medial and lateral femoral condyles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 99.5 % of knees had minimal bone wear (&lt;1\u00a0mm) at 0\u00b0 and 90\u00b0. In the 74 % (154 of 208) of knees with a varus deformity, 92 % at 0\u00b0 and 2 % at 90\u00b0 had &gt;1\u00a0mm cartilage wear on the medial femoral condyle. In the 26 % (54 of 208) of knees with a valgus deformity, 78 % at 0\u00b0 and 55 % at 90\u00b0 had \u22651\u00a0mm cartilage wear on the lateral femoral condyle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>As a general guideline, adjustment for femoral bone wear is rarely required when performing kinematically aligned TKA. Most osteoarthritic knees require adjustment of the distal referencing guide to compensate for cartilage wear on the medial femoral condyle in the varus knee and the lateral femoral condyle in the valgus knee. Adjustment of the posterior referencing guide is required in about half of valgus osteoarthritic knees to compensate for lateral cartilage wear at 90\u00b0. Knowing that bone wear is rare and cartilage wear is predictable in varus and valgus Kellgren\u2013Lawrence Grade 3 or 4 osteoarthritic knees helps establish general guidelines for adjusting the distal and posterior femoral referencing guides to restore the natural angle and level of the femoral joint lines when performing kinematically aligned TKA with generic instruments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-014-3080-8","type":"journal-article","created":{"date-parts":[[2014,5,18]],"date-time":"2014-05-18T21:59:01Z","timestamp":1400450341000},"page":"2975-2981","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":114,"title":["Femoral bone and cartilage wear is predictable at 0\u00b0 and 90\u00b0 in the osteoarthritic knee treated with total knee arthroplasty"],"prefix":"10.1002","volume":"22","author":[{"given":"Denis","family":"Nam","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Washington University School of Medicine\/Barnes\u2010Jewish Hospital St. Louis MO USA"},{"name":"Washington University Orthopedics Barnes Jewish Hospital Campus Box 8233, 660 S. Euclid Avenue 63110 St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth M.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Washington University School of Medicine\/Barnes\u2010Jewish Hospital St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M.","family":"Howell","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Graduate Group University of California Davis Davis CA USA"},{"name":"Department of Mechanical Engineering University of California Davis Davis CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maury L.","family":"Hull","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Graduate Group University of California Davis Davis CA USA"},{"name":"Department of Mechanical Engineering University of California Davis Davis CA USA"},{"name":"Department of Biomedical Engineering University of California Davis Davis CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,5,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010011\u20101936\u20105"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20120123-04"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.E.00440"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102011\u2010201164"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20262"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199305000-00033"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010012\u20102613\u2010z"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102621\u2010x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.01566"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2005.04.017"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101723\u20106"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101691\u2010x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102481\u20104"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010013\u20102898\u20106"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-014-3080-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00167-014-3080-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-014-3080-8","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T11:32:19Z","timestamp":1760873539000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-014-3080-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,20]]},"references-count":14,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2014,12]]}},"alternative-id":["10.1007\/s00167-014-3080-8"],"URL":"https:\/\/doi.org\/10.1007\/s00167-014-3080-8","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,5,20]]}}}