Accuracy of a proximal tibial cutting method using the anterior tibial border in TKA

Sasanuma, Hideyuki; Sekiya, Hiroo; Takatoku, Kenzo; Ajiki, Takashi; Hagiwara, Hiroyoshi

doi:10.1007/s00590-014-1415-2

Cited by 11 publications

(13 citation statements)

References 22 publications

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“…The ankle joint was found to be frequently externally rotated compared with the AP axis of the proximal part of the tibia [31], which caused the distal end of the extramedullary guide to be shifted laterally when placed in front of the center of the ankle joint in cases where the tibia was cut in varus. Sasanuma et al [32] conducted a clinical study examining the accuracy of cutting the proximal tibia using a line connecting the proximal and distal one-third of the anterior border of the tibia. They concluded that there was no difference in coronal alignment between the bony landmark method and the conventional method (within 3°of the target angle: 84% vs. 88%).…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Proximal Tibial Bone Cut Using Anterior Border of Tibia as Bony Landmark in Total Knee Arthroplasty

Nishikawa

Mizu-uchi

Okazaki

et al. 2015

The Journal of Arthroplasty

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The purpose of our study was to evaluate the accuracy of the tibial bone cut in total knee arthroplasty using the anterior tibial border as a guide compared to using bony and soft tissue landmarks of the ankle joint. The extramedullary alignment guide was set parallel to a line connecting the proximal and distal one-thirds of the anterior border of the tibia while the rotational direction of the distal end of the guide was adjusted to the anteroposterior axis of the proximal tibia. Significant differences were detected in the ideal coronal tibial component angles with improvements from 87.2% to 95.9%. The anterior tibial border was a reliable landmark in total knee arthroplasty in clinical practice, as shown by our previous computer simulation.

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Section: Discussionmentioning

confidence: 99%

Accuracy of Proximal Tibial Bone Cut Using Anterior Border of Tibia as Bony Landmark in Total Knee Arthroplasty

Nishikawa

Mizu-uchi

Okazaki

et al. 2015

The Journal of Arthroplasty

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“…A study by Nishikawa et al proved that the proximal one-third and the distal one-third of the anterior tibial border were reliable landmarks for the tibial extramedullary alignment guide in TKA 30 . In a clinical trial, Sasanuma et al proved that the proximal and distal one-third of the tibia provides good coronal alignment and better accuracy for the posterior tibial slope compared with the conventional method 13 . In a study by Bilgen et al, the EHL tendon is a reliable anatomical landmark to use with extramedullary guide systems and improves coronal alignment 7 .…”

Section: Discussionmentioning

confidence: 99%

“…To align the extramedullary guides to the mechanical axis of the tibia, a number of bony and soft tissue marker points have been proposed as distal tibial reference points; these include the second metatarsal 6 , the extensor hallucis longus tendon (EHLT) 7–9 , the tibialis anterior tendon (TAT) 10 , the Achilles tendon (AT) 11 , the extensor digitorum longus tendon (EDLT) 11 , and the dorsal pedal artery (DPA) 12 . In addition, in recent years, the lines connecting the proximal and distal thirds of the anterior tibial margin 13 or the medial third of the patellar ligament insertion and the distal quarter of the anterior tibial margin have been used a reference axes during tibial osteotomy 14 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy Analysis of Selection of Distal Reference Point for Tibial Coronal Plane Osteotomy during Total Knee Arthroplasty: A Literature Review

Men

Liang

Wang

et al. 2021

Orthopaedic Surgery

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Total knee arthroplasty is an effective treatment for end-stage knee osteoarthritis. The tibial platform osteotomy must take full account of the coronal plane, the sagittal plane, and the rotational alignment of the tibial prosthesis. During surgery, individual differences in the coronal alignment of the tibia need to be taken into account as poor alignment after surgery can lead to rapid wear of the tibial platform, reducing the longevity of the prosthesis and adversely affecting quality of life. Intraoperative tibial osteotomies are often performed using extramedullary alignment. When an extramedullary alignment approach is used, the proximal tibial osteotomy guide is usually placed in the medial third of the tibial tuberosity. There is no consensus on the most reliable anatomical landmarks or axes for achieving distal tibial coronary alignment. Anatomical points or reference axes that are highly reproducible and precise need to be identified. From available data it appears that most surgeons use the extensor hallucis longus tendon, the second metatarsal, and the anterior tibial cortex to determine the distal localization point. However, its accuracy has not been confirmed in clinical and radiographic data, and the alignment concept and preoperative planning for total knee arthroplasty has paid more attention to rotational alignment, but there are few studies on the coronal alignment of the tibia. This article reviews the recent use of the distal tibial coronal osteotomy reference point in total knee arthroplasty. However, due to there being only a small number of studies available, the evidence collected is insufficient to prove that a certain reference axis has obvious advantages and a combination of different reference points is needed to achieve the ideal lower extremity force line angle.

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“…Moreover, anterior tibial crest was also reported as a reliable reference for posterior slope of TKA because it is easily palpable during the operation and has less soft tissue. 8,20,21 However, the soft tissue thickness should be considered, although there is less soft tissue in that area. Tsukeoka and Tsuneizumi 9 reported that the accuracy of the sagittal reference using the line tibial cut surface and anterior skin under 20 cm using CT images to reflect the thickness of soft tissue in the anterior tibial crest and the reference was almost similar to that of the mechanical axis in the sagittal plane.…”

Section: Discussionmentioning

confidence: 99%

A sagittal reference line using the preoperative radiograph in total knee arthroplasty

Kim

Shin

et al. 2020

J Orthop Surg (Hong Kong)

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Background: We evaluated the accuracy of a sagittal alignment of tibial component in total knee arthroplasty (TKA) with the sagittal reference line using the preoperative radiograph. Methods: We evaluated 151 patients who underwent primary TKA with posterior cruciate substituting type implant. For 75 patients, the sagittal reference line using preoperative radiograph (group A) was used, while for 76 patients the sagittal reference using intraoperative fibular shaft line (group B) was used. The parallel line (line S) to the anatomical axis of the tibia in the lateral plain radiograph was used as the sagittal reference. The distance from line S to proximal tibia cutting area and to skin surface 20 cm distal to the cutting area was measured in preoperative radiographs. Next, the distance to the extramedullary guide rod was applied intraoperatively, reflecting the results. The intraoperative fibular shaft line was determined using the connecting line between the tip of fibular head and the lateral malleolus. The postoperative tibial component slope angle and the difference to the target slope angle were compared. Results: The difference to the target angle was 1.8 ± 1.3° in group A, whereas the difference was 2.5 ± 1.4° in group B ( p = 0.04). The patients with difference within 3° to the target angle were 78.7% in group A and 61.8% in group B ( p = 0.024). Conclusion: The sagittal reference line using the preoperative lateral radiograph was helpful as a reference guide for the tibial slope in TKA.

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Accuracy of a proximal tibial cutting method using the anterior tibial border in TKA

Abstract: The bony landmark method provided a more accurate posterior tibial slope than the conventional method. However, there was no difference in coronal alignment compared with the conventional method.

Cited by 11 publications

References 22 publications

Accuracy of Proximal Tibial Bone Cut Using Anterior Border of Tibia as Bony Landmark in Total Knee Arthroplasty

Accuracy of Proximal Tibial Bone Cut Using Anterior Border of Tibia as Bony Landmark in Total Knee Arthroplasty

Efficacy Analysis of Selection of Distal Reference Point for Tibial Coronal Plane Osteotomy during Total Knee Arthroplasty: A Literature Review

A sagittal reference line using the preoperative radiograph in total knee arthroplasty

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