A new landmark for measuring tibial component rotation after total knee arthroplasty

Mahmood, Fahd; Holloway, N.; Deakin, A.H.; Clarke, Jon; Picard, F.

doi:10.1016/j.knee.2018.09.002

Cited by 4 publications

(4 citation statements)

References 30 publications

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“…Through the personalized alignment method of tibial rotation, the postoperative angle θ was 0.85 ± 1.08 °(the external rotation state of tibial plateau relative to the femoral prosthesis, θ was positive; the relative internal rotation state, θ was negative) was smaller than that of the traditional operation group (7.12 ± 0.99 °).12 months after operation, angle θ of personalized and traditional group were (0.35 ± 1.03) and (6.24 ± 0.69) respectively. The difference between the two groups was statistically signi cant, and the average angle in the traditional positioning group was similar to that reported before [19,20]. And in the study of Kim et al[21], it is proposed that the external rotation of tibial prosthesis is between 2-5 °, and the service life of tibial prosthesis is longer.…”

Section: Discussionsupporting

confidence: 76%

Analysis of early curative effect of TKA surgery strategy guided by personalized tibial prosthesis rotation alignment

Yan

Liu

Yan

et al. 2022

Preprint

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Background To explore the influence of individualized positioning of tibial prosthesis rotation alignment to guide total knee arthroplasty (TKA) surgery strategy on the early postoperative effect. Method A total of 60 patients who underwent TKA in our hospital from January 2019 to March 2020 were divided into two groups: personalized operation group and traditional operation group, with 30 patients each group. The general data such as age, sex, operation time, intraoperative blood loss and hospital stay were recorded. Range of motion (ROM), visual analogue scale (VAS), knee society score (KSS), The Western Ontario and McMaster Universities Arthritis Index (WOMAC), and Oxford knee score (OKS) were recorded before, 3 months and 12 months after operation and the vertical angle between APA and STEA' was θ, the mechanical axis of lower extremities (MA) and patellofemoral index (PFI) 3 months and 12months after operation were measured to evaluate the postoperative effect. Results 3 months after operation, the ROM, VAS, KSS, vertical angle θ and PFI scores of personalized positioning group were (108.6 ± 8.27), (1.20 ± 0.56), (88.15 ± 2.54), (0.85 ± 1.08) and (0.97 ± 0.10) respectively were better than traditional operation group (102.80 ± 7.72), (2.20 ± 0.67), (83.60 ± 3.85), (7.12 ± 0.99), (1.34 ± 0.20). 12 months after operation, the ROM, VAS, KSS, vertical angle θ and PFI scores of personalized positioning group were (118.3 ± 7.26), (0.67 ± 0.48), (91.83 ± 1.74), (0.35 ± 1.03), (0.96 ± 0.15) respectively were better than traditional operation group (114.1 ± 8.09), (1.18 ± 0.83), (89.93 ± 2.50), (6.24 ± 0.69), (1.28 ± 0.19). There was no significant difference in MA, WOMAC and OKS after operation. Conclusion Personalized tibial prosthesis rotation alignment guide TKA strategy can more accurately obtain the prosthesis rotation alignment and lower limb force lines, and then guide TKA surgery, in order to achieve better results in the early postoperative period.

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Section: Discussionsupporting

confidence: 76%

Analysis of early curative effect of TKA surgery strategy guided by personalized tibial prosthesis rotation alignment

Yan

Liu

Yan

et al. 2022

Preprint

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“…Another study by Mahmood et al[ 16 ] introduced a new landmark for measuring tibial component rotation after TKA. This research underscores the importance of identifying reliable anatomical landmarks for component placement, a key aspect that aligns with our study's focus on the detailed measurements of GT.…”

Section: Discussionmentioning

confidence: 99%

Gerdy’s tubercle as a novel anatomical landmark for the proximal tibial cut in total knee arthroplasty

Özer,

Abdulaliyev,

Pelin Cavdar Yilmaz

et al. 2024

Jt Dis Relat Surg

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“…The lateral tibial cortex (LTC), described by Mahmood et al 21 , is a “flat area on the lateral cortex of the tibia inferior to the tibial component…at a depth of approximately 10 mm from the joint line.” This flat area was recreated with use of a sequence of pick points (Fig. 2-B).…”

Section: Methodsmentioning

confidence: 99%

“…Because of the lack of consensus about tibial component rotation, a number of methods referencing various parts of the tibial tubercle have been described, including the Berger, Mayo, Akagi, and Insall methods 11,17,18 . Non-tuberclereferencing markers of rotation have been described as well, including the posterior condylar axis (PCA), anterior condylar axis (ACA), and the lateral tibial crest [19][20][21] . The Cobb axis method 22 , which entails finding the centers of the best-fit circles of the medial and lateral tibial condyles, is another method that forms the basis for the concept of placing the tibial baseplate to best fit the proximal part of the tibia.…”

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confidence: 99%

Reference Axes for Tibial Component Rotation in Total Knee Arthroplasty

Jang

Davignon

Geller

et al. 2022

Journal of Bone and Joint Surgery

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Background: Many anatomic landmarks have been described for setting tibial component rotation intraoperatively.There is no consensus as to which axis is best for reducing outliers and preventing malrotation. Methods: The SOMA (Stryker Orthopaedic Modeling and Analytics) database (Stryker) was used to identify 1,351 computed tomography (CT) scans of the entire tibia. Several reference axes for the tibia (including the Mayo axis, Akagi line, Insall line, anterior condylar axis [ACA], posterior condylar axis [PCA], lateral tibial cortex [LTC], Cobb axis, tibial crest line [TCL], and transmalleolar axis [TMA]) were constructed according to published guidelines. The Berger method served as the reference standard.Results: The Mayo method (involving a line connecting the medial and middle one-thirds of the tibial tubercle and the geometric center of the tibia) and the Insall line (involving a line connecting the posterior cruciate ligament [PCL] insertion and the intersection of the middle and medial one-thirds of the tibial tubercle) both had low variability relative to the Berger method (7.8°± 1.0°and 5.1°± 2.2°, respectively) and a low likelihood of internal rotation errors (0.7% and 1.8%, respectively). No clinically significant gender-based differences were found (<0.7°for all). The same was true for ethnicity, with the exception of consistently greater tibial intorsion in Asian versus Caucasian individuals (mean difference in TCL position, 14.5°intorsion for Asian individuals; p < 0.001). Conclusions:This CT-based study of 1,351 tibiae (which we believe to be the largest study of its kind) showed that the Mayo and Insall methods (both of which reference the medial and middle one-thirds of the tibial tubercle) offer an ideal balance of accuracy, low variability, and a reduced likelihood of internal rotation errors. Setting rotation on the basis of distal landmarks (tibial shaft and beyond) may predispose surgeons to substantial malrotation errors, especially given the differences in tibial torsion found between ethnic groups in this study.

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A new landmark for measuring tibial component rotation after total knee arthroplasty

Cited by 4 publications

References 30 publications

Analysis of early curative effect of TKA surgery strategy guided by personalized tibial prosthesis rotation alignment

Analysis of early curative effect of TKA surgery strategy guided by personalized tibial prosthesis rotation alignment

Gerdy’s tubercle as a novel anatomical landmark for the proximal tibial cut in total knee arthroplasty

Reference Axes for Tibial Component Rotation in Total Knee Arthroplasty

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