The accuracy of two different extra-medullary tibial cutting guides for posterior tibial slope in total knee arthroplasty

Bek, Doğan; Ege, Tolga; Yıldız, Cemil; Tunay, Servet; Basbozkurt, Mustafa

doi:10.5606/ehc.2014.17

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…It can be compensated by insert design. In a study perfomed by Bek et al the influence of two different extramedullary tibial cutting guides on the posterior tibial slope was compared revealing that convenient with our results the slope angle was decreased in both groups with respect to the preoperative values 19 .…”

Section: Discussionsupporting

confidence: 75%

Total diz artroplastisi yaklaşımlarının komponent yerleşimine etkisi

Biçer¹,

Sözbılen²,

Aydoğdu³

et al. 2018

Cukurova Medical Journal

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ÖzPurpose: The aim of this study was to evaluate the influence of subvastus and medial parapatellar total knee arthroplasty approaches on component positioning and to explore the possible negative effects of potentially more restrictive approaches especially in highly deformed knees. Materials and Methods: 88 knees of 84 patients (46 knees operated with medial parapatellar approach (group 1), and 46 knees operated with subvastus approach (group 2)) who had undergone total knee arthroplasty. The patients were also regrouped according to their preoperative mechanical axis deviations. Postoperative femoral and tibial component positioning on frontal and sagittal planes were evaluated.

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Section: Discussionsupporting

confidence: 75%

Total diz artroplastisi yaklaşımlarının komponent yerleşimine etkisi

Biçer¹,

Sözbılen²,

Aydoğdu³

et al. 2018

Cukurova Medical Journal

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“…The difference caused by soft tissues was found to be 0.16±2.05 mm, and this did not adversely affect the alignment. However, our suggestion is that the point 3–5 mm medial to the malleolar center is a more precise reference point, as advocated by many authors 10,12,17–19…”

Section: Discussionmentioning

confidence: 78%

“…The technique using the bi-malleolar center has been reported as another significant reference point. The point located 3–5 mm medial to the malleolar center has been suggested for use as the center of the ankle 10,12,17–19. Its disadvantage is difficulty in palpation, which sometimes occurs during surgery.…”

Section: Discussionmentioning

confidence: 99%

Can Achilles tendon be used as a new distal landmark for coronal tibial component alignment in total knee replacement surgery? An observational MRI study

Tiftikçi¹,

Serbest²,

Burulday

2017

TCRM

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BackgroundIn total knee arthroplasty, it is better to use more than one reference point for correct alignment of the components. By measuring the distances of Achilles tendon (AT) and other conventional landmarks from the mechanical axis in magnetic resonance imaging (MRI) of the ankle, we aimed to demonstrate that, as a novel landmark which can help for correct alignment in the coronal plane, AT is a better option than other landmarks.Materials and methodsThis retrospective study was done on 53 ankle MRIs that met the criteria for inclusion to the study among 158 ankle MRIs. After identification of the mechanical axis, the distances of distal landmarks, which were extensor hallucis longus tendon (EHLT), tibialis anterior tendon (TAT), dorsalis pedis artery (DPA), AT, extensor digitorum longus tendon (EDLT), and malleoli, were measured from the mechanical axis and were statistically evaluated.ResultsIn proximal measurements, the distances of the landmarks to the mechanical axis (on average) were AT, 2.64±1.62 mm lateral; EHLT, 3.89±2.45 mm medial; DPA, 4.69±2.39 mm medial; TAT, 8.24±3.60 mm medial; and EDLT, 14.2±4.14 mm lateral (P<0.001). In distal measurements, the distances of the landmarks to the mechanical axis (on average) were AT, 1.99±1.24 mm medial; EHLT, 4.27±2.49 mm medial; DPA, 4.79±2.10 mm medial; TAT, 12.9±4.07 mm medial; and EDLT, 12.18±4.17 mm lateral (P<0.001).ConclusionIn this study, the mechanical axis line, which is the center of talus, passes through the AT. Our MRI investigations showed that the AT, EHLT, DPA, and malleolar center (3–5 mm medial) may help in correct alignment.

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“…In the coronal plane, the tibial bone resection needs to be perpendicular to the tibial mechanical axis. In addition to navigation and patient-speci c instrumentation, the traditional method of aligning the tibial mechanical axis is to use the proximal spike of the cutting guide to anchor the ACL attachment to the tibia [26], the anterior middle third of the anterior and posterior axis of the tibial plateau [27], and the intercondylar eminentia [28], as well as the point on the tibia plateau, resulting in the extramedullary rod being parallel to the palpable bula [27]. In the distal tibia, because the ankle joint center is di cult to locate, the second metatarsal [29], rst and second metatarsal spaces [30], tibialis anterior tendon, or anterior tibial crest [31,32] are often used as markers, and through these, generally good coronal alignment can be obtained.…”

Section: Discussionmentioning

confidence: 99%

Effects of Different Prosthetic Instrumentations on Tibial Bone Resection in Total Knee Arthroplasty

Yuan

Qiao

et al. 2020

Preprint

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Objective For total knee arthroplasty (TKA) tibial bone resection, various manufacturers provide cutting blocks with fixed angles. But the accuracy of these angles is uncertain. Our aim was to assess the accuracy of the obtained posterior tibial slope (PTS) with a fixed angle cutting block.Methods 247 TKAs in 213 patients were reviewed. We included 104 Legion Prosthesis, 76 U2 Knee Prosthesis, 46 NexGen LPS-Flex Prosthesis, and 21 Vanguard Knee System products. Preoperative and postoperative PTS were measured via expanded lateral tibia radiographs. The tibial component coronal alignment angle (TCCA) was measured on postoperative standing full-length anteroposterior radiographs, and the tibia length was measured on preoperative standing full-length radiographs. Results For postoperative PTS, the Legion group had significantly smaller slopes than the U2 Knee group and Vanguard group. However, there was no significant difference between the Legion and NexGen groups, and no significant difference among the NexGen, U2 Knee, and Vanguard groups. One sample t-test indicated that only the NexGen group showed no statistical difference from the 7° PTS and 90° TCCA it aimed to provide. Multiple linear regression showed that the different tibial lengths and preoperative PTS had statistically significant effect on postoperative PTS. However, there were weak correlations between the tibial length and PTS, and between preoperative and postoperative PTS.Conclusion For TKA, using conventional tibial bone resection technology with different tibial cutting instrumentations provided by various manufacturers can obtain safe PTS. However, the PTS is not completely consistent with the angle of the cutting block.

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The accuracy of two different extra-medullary tibial cutting guides for posterior tibial slope in total knee arthroplasty

Cited by 6 publications

References 21 publications

Total diz artroplastisi yaklaşımlarının komponent yerleşimine etkisi

Total diz artroplastisi yaklaşımlarının komponent yerleşimine etkisi

Can Achilles tendon be used as a new distal landmark for coronal tibial component alignment in total knee replacement surgery? An observational MRI study

Effects of Different Prosthetic Instrumentations on Tibial Bone Resection in Total Knee Arthroplasty

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