Evaluation of tibial rotational alignment in total knee arthroplasty: a cadaver study

Rossi, Roberto; Bruzzone, Matteo; Bonasia, Davide Edoardo; Marmotti, Antonio; Castoldi, Filippo
July 2010
Knee Surgery, Sports Traumatology, Arthroscopy;Jul2010, Vol. 18 Issue 7, p889
Academic Journal
Various techniques exist for establishing tibial rotational alignment during total knee arthroplasty (TKA). The purpose of this study is to establish the most precise and reproducible method to assess tibial component rotational alignment during TKA by comparing the flexion-extension technique (ROM) and the Posterior-lateral Corner Locked Technique (PLCL). Twenty posterior stabilized TKAs were performed on cadavers. The rotation angles of the tibial components obtained using the two techniques were evaluated. The tibial component rotation axis obtained using the ROM technique and the PLCL method averaged, respectively, 0.35° (±4.2°) externally rotated and 0.34° (±3°) internally rotated to the Akagi line. No significant differences between the two methods were found and a high correlation exists between the two techniques (Pearson’s coefficient = 0.88). The ROM and PLCL techniques are both precise and reproducible methods to assess tibial component rotation during TKA. However, while the ROM technique is dependent on the correct positioning of the femoral component and the soft tissue balancing, the PCLC method is easier if a complete visualization of the posterior-lateral corner of the cut tibial plateau is achieved.


Related Articles

  • Alignment for total knee replacement: a comparison of kinematic axis versus mechanical axis techniques. A cadaver study. Nogler, Michael; Hozack, William; Collopy, Dermot; Mayr, Eckart; Deirmengian, Gregory; Sekyra, Kathrin // International Orthopaedics;Nov2012, Vol. 36 Issue 11, p2249 

    Purpose: Standard instrumentation tries to reproduce mechanical axes based on mechanical alignment (MA) guides. A kinematic alignment (KA) technique derives its plan from pre-operative MRI-measurements. This matched-pair cadaveric study compared the resulting postoperative alignments. Methods: A...

  • A new measurement technique for the tibiofemoral contact point in normal knees and knees with TKR. De Jong, R. J.; Heesterbeek, P. J. C.; Wymenga, A. B. // Knee Surgery, Sports Traumatology, Arthroscopy;Mar2010, Vol. 18 Issue 3, p388 

    Flexion gap instability after cruciate retaining TKR allows paradoxical anterior movement of the femur during flexion. The tibiofemoral contact point (CP) moves anteriorly and produces a decrease in the lever arm of the extensor apparatus. This can provoke patellofemoral, tibiofemoral-joint pain...

  • COMPUTER-ASSISTED KNEE ARTHROPLASTY IS BETTER THAN A CONVENTIONAL JIG-BASED TECHNIQUE IN TERMS OF COMPONENT ALIGNMENT. Sk., Chauhan; Rg., Scott; W., Breidahl; Rj., Beaver // Journal of Bone & Joint Surgery, American Volume;Nov2004, Vol. 86-A Issue 11, p2573 

    The article compares the efficacy of computer-assisted knee arthroplasty (CAKA) with a conventional jig-based knee arhroplasty (JBKA) technique in patients having knee arthroplasty. CAKA was done using the Stryker Knee Navigation system which makes use of anatomical mapping of the knee and...

  • Radiographic features predictive of patellar maltracking during total knee arthroplasty. Shi-Lu Chia; Merican, Azhar M.; Devadasan, Bernard; Strachan, Robin K.; Amis, Andrew A. // Knee Surgery, Sports Traumatology, Arthroscopy;Dec2009, Vol. 17 Issue 10, p1217 

    Despite improvements in component design and surgical technique, some patients still require lateral retinacular release during TKA to improve patella tracking. We studied 148 fixed-bearing TKAs to identify parameters in pre-operative knee radiographs that would predict intraoperative patellar...

  • The influence of femoral condylar lift-off on the wear of artificial knee joints. Jennings, L. M.; Bell, C. J.; Ingham, E.; Komistek, R. D.; Stone, M. H.; Fisher, J.; Bell, C I // Proceedings of the Institution of Mechanical Engineers -- Part H;Apr2007, Vol. 221 Issue 3, p305 

    In vivo fluoroscopic studies of patients with total knee replacements (TKRs) have shown lift-off of the femoral condyles from the tibial insert. This study investigated the influence of femoral condylar lift-off on the ultra-high molecular weight polyethylene (UHMWPE) wear of fixed bearing (FB)...

  • Results of Resurfacing a Native Patella in Patients With a Painful Total Knee Arthroplasty. Khatod, Monti; Codsi, Michael; Bierbaum, Benjamin // Journal of Knee Surgery (SLACK Incorporated);Jul2004, Vol. 17 Issue 3, p151 

    Between 1990 and 2003, 24 patients (28 knees) who had a total knee arthroplasty (TKA) and underwent subsequent patella resurfacing without revision of the tibial or femoral components to alleviate pain were identified. Patient charts were reviewed retrospectively and patients were interviewed...

  • Posterior condylar offset and flexion in posterior cruciate-retaining and posterior stabilized TKA. Motoya Arabori; Nobuzo Matsui; Ryosuke Kuroda; Kiyonori Mizuno; Minoru Doita; Masahiro Kurosaka; Shinichi Yoshiya // Journal of Orthopaedic Science;Jan2008, Vol. 13 Issue 1, p46 

    Abstract Background  Anterior tibial translation associated with posterior impingement has been reported to be one of the factors limiting flexion after posterior cruciate-retaining (CR) total knee arthroplasty (TKA), especially when posterior condylar offset is decreased postoperatively....

  • Effect of bioactive coating of the tibial component on migration pattern in uncemented total knee arthroplasty: a randomized RSA study of 14 knees presented according to new RSA-guidelines. M. Therbo; B. Lund; K.-E. Jensen; H. Schrøder // Journal of Orthopaedics & Traumatology;Jun2008, Vol. 9 Issue 2, p63 

    Abstract Background  Bioactive coating of uncemented total knee arthroplasty (TKA) is believed to increase bone ingrowth and enhance early fixation of the TKA. In a prospective randomized study using radiostereometric analysis (RSA) we examined migrations of the tibial implant, in an...

  • Improving Tibial Component Coronal Alignment During Total Knee Arthroplasty with Use of a Tibial Planing Device. Patil, Shantanu; D'Lima, Darryl D.; Fait, James M.; Colwell Jr., Clifford W. // Journal of Bone & Joint Surgery, American Volume;Feb2007, Vol. 89-A Issue 2, p381 

    Background: The outcomes of knee arthroplasty have been shown to be affected by component alignment. Intramedullary and extramedullary alignment instrumentation are fairly effective for achieving the desired mean tibial component coronal alignment. However, there are outliers representing >3°...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics