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Gravity reduces the tibia when using a tibial guide that targets the intercondylar roof.

Stephen M Howell¹, Keith W Lawhorn

¹University of California, Davis, USA. sebhowell@mac.com <sebhowell@mac.com>

The American Journal of Sports Medicine

|October 21, 2004

Summary

Gravity naturally reduces the tibia relative to the femur during knee extension when using an intercondylar roof targeting guide. This method prevents tibial tunnel roof impingement without roofplasty.

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Area of Science:

Orthopedic surgery
Biomechanics

Background:

Accurate tibial tunnel placement in the sagittal plane is crucial for knee surgeries targeting the intercondylar roof.
Previous studies have not confirmed if gravity influences tibial positioning or if roof impingement is avoided without roofplasty.

Purpose of the Study:

To determine if gravity causes tibial reduction during knee extension with a tibial guide.
To assess if roof impingement is prevented without a roofplasty when using this guide.

Main Methods:

Lateral radiographs were taken of the treated knee in maximum extension with and without the tibial guide.
The contralateral normal knee in single-leg stance served as the control.

Main Results:

No significant difference in tibial position was observed with or without the tibial guide (P = .33).
The tibia was positioned only 0.7 mm more posteriorly compared to the control (P = .0075).
A roofplasty was unnecessary, with 2 mm or less of clearance observed.

Conclusions:

Gravity does reduce the tibia relative to the femur when utilizing an intercondylar roof targeting guide.
This guide effectively prevents roof impingement and posterior tibial tunnel placement without requiring a roofplasty.