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International Orthopaedics

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01-01-2020 | Computed Tomography | Review

Methods of intra- and post-operative determination of the position of the tibial component during total knee replacement

Authors: Roman Popescu, Emil G. Haritinian, Stefan Cristea

Published in: International Orthopaedics | Issue 1/2020

Abstract

Aim of the study

To identify the most reliable anatomical landmarks and imaging techniques for assessing the rotation of the tibial component in total knee arthroplasty (TKA).

Methods

An extensive literature review (from January 2016 to March 2019) was performed. We included studies about primary TKA with details concerning the anatomical landmarks used for implanting the tibial component and also imaging studies assessing tibial component rotation. The final selection comprises only thirty-five articles consistent with the inclusion criteria.

Results

Extra-articular landmarks are not always reliable (even though the tibial tubercle is one of the most popular extra-articular landmarks used to assess the rotation of the tibial component), mainly because they vary and can lead to malrotation of the tibial component. Akagi’s line (an intra-articular landmark) is considered to be the most reliable and easy to find during surgery and likewise is not affected by articular deformities. The anterior tibial cortex (intra-articular landmark) also proved to be accurate and reliable with the main advantage being that is palpable after tibial resection.

Radiography provides a good and inexpensive option for imaging, but it is insufficient. Magnetic resonance imaging (MRI) is used in some cases but not routinely for assessing TKA components or their orientation. Computed tomography (CT), used together with a well-defined protocol (Berger’s method being the preferred choice), remains the “gold standard” for evaluating the rotation of the tibial component after TKA.

Conclusion

Currently, the most accurate and reliable anatomical landmarks are represented by Akagi’s line and the anterior cortex of the tibia. Post-operatively, through CT and well-established protocols, the rotation of the tibial component can be accurately determined.

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Title: Methods of intra- and post-operative determination of the position of the tibial component during total knee replacement
Authors: Roman Popescu
Emil G. Haritinian
Stefan Cristea
Publication date: 01-01-2020
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Arthroscopy
Arthroscopy
Published in: International Orthopaedics / Issue 1/2020
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-019-04424-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Methods of intra- and post-operative determination of the position of the tibial component during total knee replacement

Abstract

Aim of the study

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Aim of the study

Methods

Results

Conclusion

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