Assessment and validation of CT scanogram to compare per-operative and post-operative mechanical axis after navigated total knee replacement

Our objective was to assess and validate low-dose computed tomography (CT) scanogram as a post-operative imaging modality to measure the mechanical axis after navigated total knee replacement. A prospective study was performed to compare intra-operative and post-operative mechanical axis after navigated total knee replacements. All consecutive patients who underwent navigated total knee replacement between May and December 2006 were included. The intra-operative final axis was recorded, and post-operatively a CT scanogram of lower limbs was performed. The mechanical axis was measured and compared against the intra-operative measurement. There were 15 patients ranging in age from 57 to 80 (average 70) years. The average final intra-operative axis was 0.56A degrees varus (4A degrees varus to 1.5A degrees valgus) and post-operative CT scanogram axis was 0.52A degrees varus (3.1A degrees varus to 1.8A degrees valgus). The average deviation from final axes to CT scanogram axes was 0.12A degrees valgus with a correlation coefficient of 0.9. Our study suggests that CT scanogram is an imaging modality with reasonable accuracy for measuring mechanical axis despite significantly low radiation. It also confirms a high level of correlation between intra-operative and post-operative mechanical axis after navigated total knee replacement.