Tibial component rotation in total knee arthroplasty

BMC Musculoskeletal Disorders

Research Article

Michael J. van Steijn¹  Jacobus J. Arts¹  Peter Z. Feczko¹  Lodewijk W. van Rhijn¹  Peter J. Emans¹  Bart G. Pijls¹ 

[1] Department of Orthopaedic Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands;

关键词: Total knee arthroplasty;    Tibial rotation;    ROM technique;    TTL technique;    Computer navigation;   

DOI  :  10.1186/s12891-016-0940-z

 received in 2015-05-07, accepted in 2016-02-10,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundBoth the range of motion (ROM) technique and the tibial tubercle landmark (TTL) technique are frequently used to align the tibial component into proper rotational position during total knee arthroplasty (TKA).The aim of the study was to assess the intra-operative differences in tibial rotation position during computer-navigated primary TKA using either the TTL or ROM techniques. The ROM technique was hypothesized to be a repeatable method and to produce different tibial rotation positions compared to the TTL technique.MethodsA prospective, observational study was performed to evaluate the antero-posterior axis of the cut proximal tibia using both the ROM and the TTL technique during primary TKA without postoperative clinical assessment. Computer navigation was used to measure this difference in 20 consecutive knees of 20 patients who underwent a posterior stabilized total knee arthroplasty with a fixed-bearing polyethylene insert and a patella resurfacing.ResultsThe ROM technique is a repeatable method with an interclass correlation coefficient (ICC2) of 0.84 (p < 0.001). The trial tibial baseplate was on average 4.56 degrees externally rotated compared to the tubercle landmark. This difference was statistically significant (p = 0.028). The amount of maximum intra-operative flexion and the pre-operative mechanical axis were positively correlated with the magnitude of difference between the two methods.ConclusionsIt is important for the orthopaedic surgeon to realise that there is a significant difference between the TTL technique and ROM technique when positioning the tibial component in a rotational position. This difference is correlated with high maximum flexion and mechanical axis deviations.

【 授权许可】

CC BY   
© Feczko et al. 2016