Total Knee Dislocation Due to Rotatory Malalignment of Tibial Component

Bargren, John H.

doi:10.1097/00003086-198003000-00049

Cited by 41 publications

(19 citation statements)

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“…But determination of the rotation by fixed anatomical landmarks can lead to rotational mismatch between the femoral and the tibial components. Incorrect kinematics caused by femorotibial rotational mismatch can cause several problems such as femoro-tibial subluxation, accelerated tibial polyethylene (PE) wear and patellofemoral dysfunction [2,4,20].…”

Section: Introductionmentioning

confidence: 99%

Synchronisation of tibial rotational alignment with femoral component in total knee arthroplasty

Lee

Seo

Moon

2007

International Orthopaedics (SICO

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The rotational axis of the tibial component in total knee arthroplasty described by Insall is generally accepted, but rotational mismatch between the femoral and the tibial components can occur because the alignment of each component is determined separately. We developed a connecting instrument to synchronise the axis of the tibia to the axis of the femur. We compared the rotational axis of the tibial component using our method and medial one third of tibial tuberosity (Insall's reference) in 70 consecutive TKAs. The rotational axis of the tibial component from the femoro-tibial synchronisation was rotated internally 13.8°± 5.8°(range, 2°-24°) more than the axis of Insall's reference. Eighty three percent of patellae tracked centrally and the patellae tilt measured 2.2°on average. More attention should be given to the rotational congruency between the femorotibial components, because the recent prosthetic design has more conforming articular surfaces.Résumé La rotation axiale du composant tibial dans la prothèse totale du genou décrite par Insall est généralement acceptée mais elle peut poser problème lorsqu'il existe un trouble de rotation sur le composant fémoral et le composant tibial du fait d'une détermination séparée de la position de chaque composant au moment de l'implantation. Nous avons pour cela développé un instrument qui permet de synchroniser l'axe du tibia et l'axe du fémur. Nous avons comparé la rotation axiale du composant tibial en utilisant notre méthode à propos de 70 prothèses totales consécutives du genou. L'axe de rotation après synchronisation des deux composants a été noté en rotation interne. Cette rotation interne est plus importante que celle prévue par l'axe de référence d'Insall qui est représenté par le tiers interne de la tubérosité tibio-intérieure. 83% des rotules avaient une course normale et un accrochage rotulien a été noté dans 2,2% en moyenne. Une attention particulière doit être portée à la congruence en rotation des éléments fémoro-tibiaux pendant l'implantation d'une PTG d'autant que cette congruence est plus importante dans les nouveaux dessins de prothèses totales du genou récentes.

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Section: Introductionmentioning

confidence: 99%

Synchronisation of tibial rotational alignment with femoral component in total knee arthroplasty

Lee

Seo

Moon

2007

International Orthopaedics (SICO

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“…1 Flexionextension mismatch with greater laxity in flexion than extension, 2 malposition of tibial component, 3 valgus deformity which requires extensive soft-tissue release 4,5 extensor mechanism deficiency, 6,7 neurologic disorders, 8 fracture of polyethylene insert itself 9 and small insert usage in mobile-bearing revision TKA 10 are among reported etiologies. But, none of the cases in the literature is with the fracture of tibia.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous posterior dislocation of primary total knee arthroplasty with ipsilateral tibial shaft fracture: A case report and review of literature

Öztürk

Akalın

Çevik

et al. 2016

Journal of Clinical Orthopaedics and Trauma

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“…Various techniques are used to ensure optimal alignment, but there is a lack of reliability and repeatability [1]. In a study of 109 TKAs, 50% were found to have tibial malrotation of more than 5 [3], which is sufficient to result in knee pain, a poor range of motion and instability [4,5]. Moreover, rotational malalignment causes abnormal eccentric loading of the tibial component during flexion of the knee, when the femur rides upwards on the disk-shaped tibial components.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, rotational malalignment causes abnormal eccentric loading of the tibial component during flexion of the knee, when the femur rides upwards on the disk-shaped tibial components. Such eccentric loading will greatly reduce the forces necessary to loosen the prosthesis [4]. In fixed-bearing TKA designs, medial rotation of the tibia can adversely affect patellofemoral tracking and can cause patellar dislocation [6].…”

Section: Introductionmentioning

confidence: 99%

“…The first uses anatomical landmarks, whereby the tibial component is centered on the tibial tuberosity (or slightly medial to it) to align it with the primary motor of the knee, the quadriceps mechanism. Any deviation from this position tends to apply inappropriate rotational forces to the implant [4,10]. The second approach, which avoids reference to anatomical landmarks, is the range-of-movement (ROM) technique, in which the knee is put through a full range of flexion and extension, allowing the trial tibial implant to orient itself in the best position relative to the femoral component [11].…”

Section: Introductionmentioning

confidence: 99%

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Reliability of frames of reference used for tibial component rotation in total knee arthroplasty

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Deakin

Payne

et al. 2011

Computer Aided Surgery

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This study evaluated seven different frames of reference used for tibial component rotation in total knee arthroplasty (TKA) to determine which ones showed good reliability between bone specimens.An optoelectronic system based around a computer-assisted surgical navigation system was used to measure and locate 34 individual anatomical landmarks on 40 tibias. Each particular frame of reference was reconstructed from a group of data points taken from the surface of each bone. The transverse axis was used as the baseline to which the other axes were compared, and the differences in angular rotation between the other six reference frames and the transverse axis were calculated.There was high variability in the tibial rotational alignment associated with all frames of reference. Of the references widely used in current TKA procedures, the tibial tuberosity axis and the anterior condylar axis had lower standard deviations (6.1 and 7.3 , respectively) than the transmalleolar axis and the posterior condylar axis (9.3 for both). In conclusion, we found high variability in the frames of reference used for tibial rotation alignment. However, the anterior condylar axis and transverse axis may warrant further tests with the use of navigation. Combining different frames of reference such as the tibial tuberosity axis, anterior condylar axis and transverse axis may reduce the range of errors found in all of these measurements.

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Total Knee Dislocation Due to Rotatory Malalignment of Tibial Component

Cited by 41 publications

References 0 publications

Synchronisation of tibial rotational alignment with femoral component in total knee arthroplasty

Synchronisation of tibial rotational alignment with femoral component in total knee arthroplasty

Simultaneous posterior dislocation of primary total knee arthroplasty with ipsilateral tibial shaft fracture: A case report and review of literature

Reliability of frames of reference used for tibial component rotation in total knee arthroplasty

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