Tibial component rotation during the unicompartmental knee arthroplasty: is the anterior superior iliac spine an appropriate landmark?

Lee, Seung Yup; Chay, Suhwoo; Lim, Hong Chul; Bae, Ji Hoon

doi:10.1007/s00167-016-4192-0

Cited by 18 publications

(19 citation statements)

References 28 publications

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“…However, all measures demonstrated good agreement, also on radiographs. 97 For assessment of tibial component rotation, Akagi’s anteroposterior (AP) line (medial edge of patellar tendon to middle of posterior cruciate ligament (PCL) can be used as rotational reference for the tibial component on CT. 98 - 100 …”

Section: Resultsmentioning

confidence: 99%

A structured evaluation of the symptomatic medial Oxford unicompartmental knee arthroplasty (UKA)

et al. 2021

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Unicompartmental knee arthroplasty (UKA) has several advantages over total knee arthroplasty; however, in many reports, the risk of revision remains higher after UKA. Many reasons for failure of UKA exist. Successful treatment starts with accurate assessment of the symptomatic UKA as a specific mode of failure requires a specific solution. A structured and comprehensive evaluation aids assessment of the symptomatic UKA. This review provides an overview of the causes for a symptomatic medial UKA, its risk factors, diagnostic modalities that can be used, and briefly discusses treatment options. Cite this article: EFORT Open Rev 2021;6:850-860. DOI: 10.1302/2058-5241.6.200105

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Section: Resultsmentioning

confidence: 99%

A structured evaluation of the symptomatic medial Oxford unicompartmental knee arthroplasty (UKA)

et al. 2021

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“…The tibial component tends to rotate externally, due to the lack of a distinct landmark for tibial component rotation in the small operating field. 26 Although the ideal tibial component rotation in UKA is well debated, the direct relationship between postoperative tibial component rotation and clinical outcomes is not clearly described.…”

Section: Discussionmentioning

confidence: 99%

Radiographic and Clinical Evolution of the Oxford Unicompartmental Knee Arthroplasty

et al. 2021

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The aim of the study is to evaluate whether the use of the new instrumentation Microplasty (MP) improves component positioning and the reliability of the surgical technique, reducing the implant outliers from the recommended range and providing a more accurate resection, while avoiding insufficient or excessive tibial resection and clinical scores. We prospectively analyzed clinical and radiographic outcomes of three consecutive cohorts for a total of 227 implants at a minimum follow-up of 36 months. The first cohort consisted of 67 Oxford unicompartmental knee arthroplasty (OUKA), using the phase III (Ph-III). The second cohort consisted of 136 OUKA, with the MP instrumentation. The third cohort consisted of 24 hypoallergenic OUKA, using the MP instrumentation (TiNbN). Postoperative alignment of the knee in the coronal and sagittal plane was measured using radiographs. No clinical differences were found among the three groups (p > 0.05). A significant difference was found on the slope between Ph-III and MP (p = 0.0005). Moreover, a significant difference was found in tibial angle and in tibial slope in arthroplasty with femoral size small (S), compared with size medium (M) or large (Ly) (tibia varus/valugs angle: p = 0.0484; tibial slope: p = 0.04). Similar results were found between small (AA, A, B) tibial size and large (C, D, E, F) tibial size for tibial varus/valgus (p = 0.03) angle and tibial slope (p = 0.003). A significant difference was found between Ph-III and MP in tibial slope in patients with body mass index (BMI) ≥25 kg/m2 (p = 0.0003). A positive correlation was noted between the femoral and tibial sizes and the tibial angle and the slope, and a negative correlation between weight and the tibial slope; furthermore, a positive correlation was found between Oxford knee score and radiographic angles. The MP instrumentation seems to be effective in determining the tibial cut and, particularly, improving the tibial slope, compared with Ph-III. The tibial slope is directly affected by the weight and measurements of the components, regardless of the instruments or the number of pegs, while clinical outcomes are correlated with implant position. This prospective comparative study reflects level of evidence II.

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“…Two other studies showed that the external rotation angle was 6.5 AE 5.1 and 11.9 (range, À1 -32 ) relative to the line perpendicular to the tangent of the posterior tibial cortex. 8,15 With respect to the Oxford mobile-bearing tibial components, Lee et al 11 reported that the tibial component was implanted with This indicates that the direction of the standard tibial vertical cut did not guarantee a fixed rotation angle in which the tibial component was implanted. We placed the tibial component just along the tibial vertical cut without adjusting its rotation and coronal coverage, and we found no statistically significant differences in the tibial component size between the groups.…”

Section: Discussionmentioning

confidence: 99%

Effect of vertical cut on coronal coverage and rotation of tibial component in Oxford unicompartmental knee arthroplasty

et al. 2020

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Objective This study was performed to investigate the influence of a standard Oxford vertical cut on the coronal coverage and rotation of the tibial component and determine whether a relationship exists between coverage and rotation. Methods We retrospectively analyzed 71 patients with anteromedial osteoarthritis of the knee treated by Oxford unicompartmental knee arthroplasty in one center from October 2016 to October 2017. The distance of coronal coverage was measured on a postoperative anteroposterior view of the tibial component. Two different reference lines between the lateral wall of the tibial component were defined as rotation angle α and β, respectively, on a computed tomography scan. Results The mean distance was 0.3 ± 1.1 mm. The mean angle α and β were 5.7° ± 4.6° and 8.4° ± 4.6°, respectively. There were no significant differences in the distance according to the tibial component rotation or in the α and β angles according to the coronal coverage. No significant correlation was found between the α and β angles and the distance. Conclusion A standard tibial vertical cut caused various changes in coronal coverage and rotation of the tibial component. The rotation of the tibial component did not affect coverage within a certain range.

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Tibial component rotation during the unicompartmental knee arthroplasty: is the anterior superior iliac spine an appropriate landmark?

Abstract: IV.

Cited by 18 publications

References 28 publications

A structured evaluation of the symptomatic medial Oxford unicompartmental knee arthroplasty (UKA)

A structured evaluation of the symptomatic medial Oxford unicompartmental knee arthroplasty (UKA)

Radiographic and Clinical Evolution of the Oxford Unicompartmental Knee Arthroplasty

Effect of vertical cut on coronal coverage and rotation of tibial component in Oxford unicompartmental knee arthroplasty

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