Extramedullary Tibial Bone Cutting Using Medial Cortical Line in Total Knee Arthroplasty
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Purpose: This study aims to identify the effectiveness of the medial cortical line for attaining a more accurate tibial component alignment in proximal tibial resection using an extramedullary alignment rod.Materials and Methods: The study examined 100 cases of total knee arthroplasty performed from December 2013 to February 2014 in a retrospective manner. On a preoperative anteroposterior (AP) radiograph of the entire tibia, we identified the medial cortical line that runs parallel to the tibial anatomical axis and passes the medial tibial spine, and measured the point where the medial cortical line crosses between the medial malleolus and the lateral malleolus in the ankle joint. Results: The preoperative AP radiograph of the tibia showed the medial cortical line passing the point 40.4%±0.8% medial to the distance from the medial malleolus to the lateral malleolus including the skin thickness in the ankle joint. When the proximal tibial resection was performed with the extramedullary tibial cutting guide aligned with the medial cortical line, the tibial component angle averaged 0.7°±0.3° varus and the alignment accuracy of the tibial component within 0°±3° varus amounted to 97.0%. Conclusions: The use of the medial cortical line in proximal tibial resection with an extramedullary tibial cutting guide allowed for relatively accurate alignment of the tibial component.
Abstract
Purpose: This study aims to identify the effectiveness of the medial cortical line for attaining a more accurate tibial component alignment in proximal tibial resection using an extramedullary alignment rod.Materials and Methods: The study examined 100 cases of total knee arthroplasty performed from December 2013 to February 2014 in a retrospective manner. On a preoperative anteroposterior (AP) radiograph of the entire tibia, we identified the medial cortical line that runs parallel to the tibial anatomical axis and passes the medial tibial spine, and measured the point where the medial cortical line crosses between the medial malleolus and the lateral malleolus in the ankle joint. Results: The preoperative AP radiograph of the tibia showed the medial cortical line passing the point 40.4%±0.8% medial to the distance from the medial malleolus to the lateral malleolus including the skin thickness in the ankle joint. When the proximal tibial resection was performed with the extramedullary tibial cutting guide aligned with the medial cortical line, the tibial component angle averaged 0.7°±0.3° varus and the alignment accuracy of the tibial component within 0°±3° varus amounted to 97.0%. Conclusions: The use of the medial cortical line in proximal tibial resection with an extramedullary tibial cutting guide allowed for relatively accurate alignment of the tibial component.
참고문헌 (17)
- Ritter MA, "Postoperative alignment of total knee replacement. Its effect on survival", Clin Orthop Relat Res, (299), pp.153~156 (1994)
- Matsuda S, "Effect of femoral and tibial component position on patellar tracking following total knee arthroplasty : 10-year follow-up of Miller-Galante I knees", Am J Knee Surg, 14, pp.152~156 (2001)
- Liau JJ, "The effect of malalignment on stresses in polyethylene component of total knee prostheses : a finite element analysis", Clin Biomech(Bristol, Avon), 17, pp.140~146 (2002)
- D’Lima DD, "Polyethylene contact stresses, articular congruity, and knee alignment", Clin Orthop Relat Res, (392), pp.232~238 (2001)
- Werner FW, "The effect of valgus", varus malalignment on load distribution in total knee replacements, 2005, pp.38, 349~355
- Jeffery RS, "Coronal alignment after total knee replacement", J Bone Joint Surg Br, 73, pp.709~714 (1991)
- Hernandez-Vaquero D, "Can computer assistance improve the clinical and functional scores in total knee arthroplasty?", Clin Orthop Relat Res, 469, pp.3436~3442 (2011)
- Fang DM, "Coronal alignment in total knee arthroplasty: just how important is it?", J Arthroplasty, 24(6 Suppl), pp.39~43 (2009)
- Tsukeoka T, "The tibial crest as a practical useful landmark in total knee arthroplasty", Knee, 21, pp.283~289 (2014)
- Akagi M, "Estimation of frontal alignment error of the extramedullary tibial guide on the bi-malleolar technique : a simulation study with magnetic resonance imaging", Knee, 19, pp.836~842 (2012)
- Rajadhyaksha AD, "Use of tibialis anterior tendon as distal landmark for extramedullary tibial alignment in total knee arthroplasty: an anatomical study", Am J Orthop (Belle Mead NJ), 38, pp.E68~E70 (2009)
- Schneider M, "Use of palpable tendons for extramedullary tibial alignment in total knee arthroplasty", J Arthroplasty, 22, pp.219~226 (2007)
- Tew M, "Tibiofemoral alignment and the results of knee replacement", J Bone Joint Surg Br, 67, pp.551~556 (1985)
- Sugimura N, "The dorsal pedis artery as a new distal landmark for extramedullary tibial alignment in total knee arthroplasty", Knee Surg Sports Traumatol Arthrosc, 22, pp.2618~2622 (2014)
- Fukagawa S, "Anterior border of the tibia as a landmark for extramedullary alignment guide in total knee arthroplasty for varus knees", J Orthop Res, 29, pp.919~924 (2011)
- Maestro A, "Influence of intramedullary versus extramedullary alignment guides on final total knee arthroplasty component position : a radiographic analysis", J Arthroplasty, 13, pp.552~558 (1998)
- Teter KE, "Accuracy of intramedullary versus extramedullary tibial alignment cutting systems in total knee arthroplasty", Clin Orthop Relat Res, (321), pp.106~110 (1995)
