{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T08:34:04Z","timestamp":1793176444560,"version":"4.5.0"},"reference-count":44,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T00:00:00Z","timestamp":1594944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T00:00:00Z","timestamp":1594944000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T00:00:00Z","timestamp":1594944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To describe a strategy for coronal alignment using a computed tomography (CT) based custom total knee arthroplasty (TKA) system, and to evaluate the agreement between the planned and postoperative Hip\u2013Knee\u2013Ankle (HKA) angle, Femoral Mechanical Angle (FMA) and Tibial Mechanical Angle (TMA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From a consecutive series of 918 primary TKAs, 266 (29%) knees received CT\u2010based posterior\u2010stabilized cemented custom TKA. In addition to a preoperative CT\u2010scan, pre\u2010 and post\u2010operative radiographs of weight\u2010bearing long leg, anterior\u2013posterior and lateral views of the knee were obtained, on which the FMA, TMA and HKA angles were measured. CT\u2010based three\u2010dimensional (3D) models enabled to correct for cases with bony wear by referring to the non\u2010worn areas and to estimate the native pre\u2010arthritic angles. The alignment technique aimed to preserve or restore constitutional alignment (CA) within predetermined limits, by defining a \u2018target zone\u2019 based on three criteria: 1) a\u2009\u00b1\u20093\u00b0 (range 87\u00b0\u201393\u00b0) primary tolerance for the femoral and tibial resections; 2) a\u2009\u00b1\u20092\u00b0 secondary tolerance for component obliquity, extending the bounds for FMA and TMA (range 85\u00b0\u201395\u00b0); 3) a planned HKA angle range of 175\u00b0\u2013183\u00b0. Agreement between preoperative, planned and postoperative measurements of FMA, TMA and HKA angle were calculated using intra\u2010class correlation coefficients (ICC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Preoperative radiograph and CT\u2010scan measurements revealed that, respectively, 73 (28%) and 103 (40%) knees were in the \u2018target zone\u2019, whereas postoperative radiographs revealed that 217 (84%) TKAs were in the \u2018target zone\u2019. Deviation from the planned angles were \u2212 0.5\u00b0\u2009\u00b1\u20091.8\u00b0 for FMA, \u2212 0.5\u00b0\u2009\u00b1\u20091.8\u00b0 for TMA, and \u2212 1.1\u00b0\u2009\u00b1\u20092.1\u00b0 for HKA angle. Finally, the agreement between the planned and achieved targets, indicated by ICC, were good for FMA (0.701), fair for TMA (0.462) and fair for HKA angle (0.472).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Using this strategy for coronal alignment, 84% of custom TKAs were within the \u2018target zone\u2019 for FMA, TMA and HKA angles. These findings support the concepts of emerging personalized medicine technologies, and emphasise the importance of accurate strategies for preoperative planning, which are key to achieving satisfactory \u2018personalised alignment\u2019 that can further be improved by customisation of implant components.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00167-020-06153-8","type":"journal-article","created":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T18:02:32Z","timestamp":1595008952000},"page":"464-475","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Custom total knee arthroplasty facilitates restoration of constitutional coronal alignment"],"prefix":"10.1002","volume":"30","author":[{"given":"Michel P.","family":"Bonnin","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Centre Orthop\u00e9dique Santy H\u00f4pital Priv\u00e9 Jean Mermoz, Ramsay Sant\u00e9 Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Beckers","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Centre Orthop\u00e9dique Santy H\u00f4pital Priv\u00e9 Jean Mermoz, Ramsay Sant\u00e9 Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustin","family":"Leon","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Centre Orthop\u00e9dique Santy H\u00f4pital Priv\u00e9 Jean Mermoz, Ramsay Sant\u00e9 Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jules","family":"Chauveau","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Centre Orthop\u00e9dique Santy H\u00f4pital Priv\u00e9 Jean Mermoz, Ramsay Sant\u00e9 Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0855-3852","authenticated-orcid":false,"given":"Jacobus H.","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> ReSurg SA Rue Saint Jean 22 1260 Nyon Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten O.","family":"Tibesku","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> KniePraxis Straubing Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarik","family":"A\u00eft\u2010Si\u2010Selmi","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Centre Orthop\u00e9dique Santy H\u00f4pital Priv\u00e9 Jean Mermoz, Ramsay Sant\u00e9 Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,17]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.01587"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.02.028"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2018.05.017"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-011-1936-5"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199811000-00021"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00132-003-0586-z"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-009-1009-4"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-1119-9"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4136-8"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00132-018-3637-1"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.96B7.32812"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2009.04.034"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05428-z"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05507-1"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05508-0"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05509-z"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20190424-02"},{"key":"e_1_2_9_19_2","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1016\/B978-1-4377-1503-3.00120-7","volume-title":"Kinematic alignment in total knee arthroplasty. 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June 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 August 2020","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s00167-020-06238-4","URL":"https:\/\/doi.org\/10.1007\/s00167-020-06238-4","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"MPB reports personal fees from DePuy Synthes, Wright Medical, Integra and Symbios. LB has nothing to declare. AL has nothing to declare. JC has nothing to declare. JHM has nothing to declare. COT reports personal fees from Symbios and Smith & Nephew. TASS reports personal fees from DePuy-Synthes and from Symbios.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All patients had provided written informed consent for the use of their data and images for research and publishing purposes and the institutional review board approved the study in advance (IRB reference number: COS-RGDS-2019-10-004-BONNIN-M; Ramsay Sante\u0301 Comite\u0301 d\u2019Ethique; +33 (0)1 87 86 22 97; Dr Sylviane Olschwang).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}