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e, f Orthogonal radiographs showing realignment of mechanical axis with healing of the osteotomy site after removal of frame.
The basis for treatment is a highly specific, problem-adapted therapy with a defined strategy, the paramount goal being to preserve the stable weightbearing bones, maintain a good mechanical axis with correctly working muscles and joints, and avoid permanent disability.
The mechanical axis deviation (MAD) was measured pre-operatively and at the most recent assessment using standing, long-alignment radiographs to determine the location of the mechanical axis with respect to the center of the tibial surface, as described by Kennedy and White.
Open image in new window Fig. 4 a Draw the normal mechanical axis of the femur (red line) by extending that of the tibia up, then draw the "resolution" anatomical axis of the lower femoral segment (blue line) referenced to the mechanical axis with an AMA angle as derived from the equation.
Mechanical axis with 3° valgus is an ideal degree.
The femoral component, which has straight femoral groove and multiple radii in sagittal plane, was implanted with an external rotation of 3 degrees relative to the posterior femoral condyles, the tibial component was implanted at zero degrees to the mechanical axis with no tibial slope of the tibial baseplate.
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However, several authors report superior long-term survivorship of TKA with a leg mechanical axis within 3° of the ideal angle [ 4, 21].
Computer tomography scanograms and mechanical axis view with grids were done to assess LLD.
The correction of mal-alignment of the mechanical axis is associated with unpredictable result and with higher revision rates.
Radiographically patients had medial OA no greater than Ahlbäck grade 2 and had an abnormal mechanical axis deviation (MAD) with varus deformity.
Analysis of the acquired anatomical data showed that the tibial tunnel was performed in the in the postero-medial part of the native ACL insertion and from anterior to posterior at 26 ± 4° with respect to the mechanical axis of the leg, coinciding with the long tibial axis, in the sagittal view [ 13].
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