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Anterior tibial curved cortex is a reliable landmark for tibial rotational alignment in total knee arthroplasty

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Authors
Kim, Joong Il; Jang, Jak; Lee, Ki Woong; Han, Hyuk Soo; Lee, Sahnghoon; Lee, Myung Chul
Issue Date
2017-06-12
Publisher
BioMed Central
Citation
BMC Musculoskeletal Disorders, 18(1):252
Keywords
Total knee arthroplastyRotational alignmentTibial component rotationAnatomical landmarkAnterior tibial curved cortex
Abstract
Background
Rotational alignment of the tibial component is important for long-term success of total knee arthroplasty (TKA). This study aimed to compare five axes in normal and osteoarthritic (OA) knees to determine a reliable landmark for tibial rotational alignment in TKA.

Methods
One hundred twenty patients with OA knees and 40 with normal knees were included. The angle between a line perpendicular to the surgical transepicondylar axis and each of five axes were measured on preoperative computed tomography. The five axes were as follows: a line from the center of the posterior cruciate ligament (PCL) to the medial border of the patellar tendon (PCL-PT), medial border of the tibial tuberosity (PCL-TT1), medial one-third of the tibial tuberosity (PCL-TT2), and apex of the tibial tuberosity (PCL-TT3), as well as the anteroposterior axis of the tibial prosthesis along the anterior tibial curved cortex (ATCC).

Results
For all five axes tested, the mean angles were smaller in OA knees than in normal knees. In normal knees, the angle of the ATCC axis had the smallest mean value and narrowest range (1.6° ± 2.8°; range, −1.7°–7.7°). In OA knees, the mean angle of the ATCC axis (0.8° ± 2.7°; range, −7.9°–9.2°) was larger than that of the PCL-TT1 axis (0.3° ± 5.5°; range, −19.7°–10.6°) (P = 0.461), while the angle of the ATCC axis had the smallest SD and narrowest range.

Conclusion
The ATCC was found to be the most reliable and useful anatomical landmark for tibial rotational alignment in TKA.
ISSN
1471-2474
Language
English
URI
http://hdl.handle.net/10371/117733
DOI
https://doi.org/10.1186/s12891-017-1609-y
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College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
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