Takenori Tomite1,2, Hidetomo Saito3,2, Hiroaki Kijima3,2, Kimio Saito3,2, Hiroshi Tazawa1, Noriyuki Ishikawa1, Naohisa Miyakoshi3, Yoichi Shimada3,2. 1. Department of Orthopedic Surgery, Akita Red Cross Hospital, Kamikitate Sarutaazanaeshirosawa 222-1, Akita City, Akita, 018-1495, Japan. 2. Akita Sports, Arthroscopy, and Knee Group (ASAKG), Hondou 1-1-1, Akita City, Akita, 010-8543, Japan. 3. Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Hondou 1-1-1, Akita City, Akita, 010-8543, Japan.
Abstract
OBJECTIVE: Sagittal alignment of the tibia following total knee arthroplasty (TKA) can affect various factors, such as durability, range of motion, stability, and even kinematics. The aim of the present study was to investigate whether taking plain preoperative lateral leg X-ray images to plan the posterior tibial slope can give an insert placement with more accurate sagittal alignment. METHODS: A total of 100 patients who underwent total TKA with posterior-stabilized prostheses. were divided into a group of 50 cases in which the posterior tibial slope was determined intra-operatively with only the fibular axis as the landmark, and a group of 50 cases in which determination of the posterior tibial slope was planned preoperatively with reference to preoperative lateral leg images. For the posterior slope, tibial cutting was performed with the posterior slope built into the bone cutting guide of the insert as the target. The angle of the fibular axis and the posterior slope of the tibial insert were measured on the postoperative lateral leg X-ray image, and the difference from the target angle was examined in the two groups. RESULTS: In the group in which only the fibular axis was used for reference, the mean deviation from the target was 3.96°, while in the group in which planning was carried out preoperatively using lateral leg X-ray images, the mean deviation was 1.59° (P < 0.05). CONCLUSION: Drawing up a preoperative plan using lateral leg X-ray images gives a useful landmark at low cost for accurate determination of TKA posterior tibial slope.
OBJECTIVE: Sagittal alignment of the tibia following total knee arthroplasty (TKA) can affect various factors, such as durability, range of motion, stability, and even kinematics. The aim of the present study was to investigate whether taking plain preoperative lateral leg X-ray images to plan the posterior tibial slope can give an insert placement with more accurate sagittal alignment. METHODS: A total of 100 patients who underwent total TKA with posterior-stabilized prostheses. were divided into a group of 50 cases in which the posterior tibial slope was determined intra-operatively with only the fibular axis as the landmark, and a group of 50 cases in which determination of the posterior tibial slope was planned preoperatively with reference to preoperative lateral leg images. For the posterior slope, tibial cutting was performed with the posterior slope built into the bone cutting guide of the insert as the target. The angle of the fibular axis and the posterior slope of the tibial insert were measured on the postoperative lateral leg X-ray image, and the difference from the target angle was examined in the two groups. RESULTS: In the group in which only the fibular axis was used for reference, the mean deviation from the target was 3.96°, while in the group in which planning was carried out preoperatively using lateral leg X-ray images, the mean deviation was 1.59° (P < 0.05). CONCLUSION: Drawing up a preoperative plan using lateral leg X-ray images gives a useful landmark at low cost for accurate determination of TKA posterior tibial slope.
Entities:
Keywords:
Posterior tibial slope; Sagittal alignment; Total knee arthroplasty
Authors: Ryan Jahn; Joseph D Cooper; Tristan Juhan; Hyunwoo P Kang; Ioanna K Bolia; Seth C Gamradt; George F Hatch; Alexander E Weber Journal: Orthop J Sports Med Date: 2021-10-07