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European Journal of Orthopaedic Surgery & Traumatology

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01-01-2017 | Original Article • KNEE - ARTHOPLASTY

Evaluation of the rotational alignment of the tibial component in total knee arthroplasty: position prioritizing maximum coverage

Authors: Masashi Hirakawa, Masashi Miyazaki, Shinichi Ikeda, Yoshiki Matsumoto, Makoto Kondo, Hiroshi Tsumura

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 1/2017

Abstract

Background

The standard for rotational alignment of the tibial component in total knee arthroplasty (TKA) remains unclear. Cases often require positioning of the tibial component, prioritizing adequate coverage of resected bone surface rather than alignment with the tibial rotational axis. We investigated tibial component position in TKA, prioritizing maximum coverage of resected bone surface, and evaluated the correlation with the tibial anteroposterior (AP) axis.

Methods

We analyzed preoperative computed tomography images for primary TKA in 106 cases and 157 knees, using three-dimensional planning software. Tibial component position prioritizing maximum coverage of resected bone surface was simulated, and results were compared with the AP axis. Rotational alignment angle was defined as that between a line perpendicular to the tibial AP axis and a line connecting the posterior edge of the tibial component.

Results

The simulated tibial component was more externally rotated by a mean 4.5° ± 4.2°. The alignment angle showed normal distribution, but variability was large, ranging from 5.1° internal rotation to 16.2° external rotation. In 138 of 157 (87.9 %) knees, the tibial component was positioned in the externally rotated position with respect to the AP axis. The tibial component was aligned within the medial one-third of the patellar tendon in 122 of 157 (77.7 %) knees.

Conclusions

The tibial component aligned using coverage prioritizing was externally rotated, although large variability was observed. Rotational alignment was optimal in 79 % of cases when the tibial component was aligned with coverage prioritizing, but hyperexternal rotation was observed in patients with severe knee deformation.

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Title: Evaluation of the rotational alignment of the tibial component in total knee arthroplasty: position prioritizing maximum coverage
Authors: Masashi Hirakawa
Masashi Miyazaki
Shinichi Ikeda
Yoshiki Matsumoto
Makoto Kondo
Hiroshi Tsumura
Publication date: 01-01-2017
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 1/2017
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-016-1850-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Evaluation of the rotational alignment of the tibial component in total knee arthroplasty: position prioritizing maximum coverage

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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