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alliedacademies Joint Event on
Global Women Health 2018 & Orthopedics Congress 2018 Archives of General Internal Medicine | ISSN: 2591-7951 | Volume 2
BREAST CANCER, GYNECOLOGY AND WOMEN HEALTH
ORTHOPEDICS AND RHEUMATOLOGY
&
World Congress on
Annual Conference on
Ervin Chino N Tayag et al., Arch Gen Intern Med 2018, Volume 2 | DOI: 10.4066/2591-7951-C3-009
WHICH WHITESIDE’S LINE?
Ervin Chino N Tayag and Syquia J F
University of Santo Tomas Hospital, Philippines
Background: The anteroposterior axis (Whiteside’s line) of the distal femur
has been used to orient the femoral component in total knee arthroplasty.
Although initially described as a line connecting the deepest point in the
patellar groove and the center of the intercondylar notch, others have used a
line connecting the deepest point in the patellar groove to the highest point
of the intercondylar notch. Furthermore, depending on the system used, the
axis could be determined on the distal femur before or after the distal femoral
cut has been made.
Objective: The objective of this study is to determine the value of Whiteside’s
line varied depending on which landmarks were used and on whether it is
taken before or after the distal femoral cut.
Methods: The following landmarks were identified from the distal femur of 40
knees: deepest point of the patellar groove, highest point of the intercondylar
notch, center of the intercondylar notch, lateral epicondylar prominence, and
medial epicondylar prominence. Three lines were drawn: one connecting
the patellar groove to the highest point of the intercondylar notch (line A);
one connecting the patellar groove to the center of the notch (line B); and
one connecting the epicondyles (transepicondylar axis). The distal femur
was cut using a total knee distal femoral cutting instrumentation. The same
landmarks and lines were identified. The angles subtended by the various
lines against a line perpendicular to the transepicondylar axis were recorded.
Values in internal rotation were assigned negative numbers while values in
external rotation were assigned positive numbers.
Results: The mean results of lines A and B in both the uncut and cut distal
femurs were negative. Line Ameasurements tended to be more negative than
line B measurements. However, there were no statistical differences among
the various measurements taken.
Conclusion: Based on this report, measurements taken from the deepest
point of the patellar groove to either the highest point of the notch or the
center of the notch may be used to determine Whiteside’s line. Furthermore,
the results will not be statistically different if taken before or after cutting the
distal femur. However, since it is beneficial to avoid internal rotation of the
femoral component in total knee replacement, the use of the center of the
notch may be a better option than the use of the apex of the notch.
Ervin Chino N Tayag did his degree of BS Biology and
Medicine from the University of Santo Tomas in Ma-
nila, Philippines. He is currently, the Chief Resident of
the Department of Orthopedics of the University of
Santo Tomas Hospital. His interests are in adult re-
construction and sports medicine.
BIOGRAPHY