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Related Experiment Video

Updated: May 16, 2026

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
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Simple method for confirming tibial osteotomy during total knee arthroplasty.

Hirotaka Mutsuzaki1, Kotaro Ikeda

  • 1Department of Orthopaedic Surgery, Ichihara Hospital, 3681 Ozone, Tsukuba, Ibaraki, 300-3295, Japan. drikeda@mac.com.

Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology : SMARTT
|November 17, 2012
PubMed
Summary

This study presents a simple method using a protractor to confirm tibial osteotomy accuracy during total knee arthroplasty (TKA). The technique demonstrated satisfactory results in achieving precise implant alignment for better patient outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Surgical Navigation

Background:

  • Precise implant alignment is critical for successful total knee arthroplasty (TKA) outcomes.
  • Inaccurate tibial osteotomy can lead to poor functional results and implant complications.
  • Current methods for assessing osteotomy accuracy may be complex or time-consuming.

Purpose of the Study:

  • To introduce and validate a straightforward method for confirming tibial osteotomy accuracy during TKA.
  • To assess the reliability of a novel protractor-based technique in achieving the desired coronal alignment.
  • To improve intraoperative decision-making and reduce the risk of malalignment in TKA.

Main Methods:

  • A simple technique involving two skin markers (tibial tuberosity and crest) placed 20 cm apart was used.

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  • Anteroposterior radiographs were obtained to define the tuberosity line and calculate the osteotomy angle relative to the tibial axis.
  • A protractor was utilized to set and verify the osteotomy angle, guiding bone cuts.
  • Postoperative analysis of 35 TKAs evaluated the varus angle of the tibial osteotomy.

    • Main Results:

    • The average varus angle of the tibial osteotomy was 89.4° ± 1.6°, which was not significantly different from the target of 90° (p=0.055).
    • 42.9% of osteotomies achieved an angle of exactly 90°, and 82.9% were within ±2° of the target.
    • The protractor method proved effective in intraoperative assessment and correction of tibial alignment.

    Conclusions:

    • The protractor-based method for tibial osteotomy in TKA provides satisfactory accuracy in the coronal plane.
    • This technique offers a simple and reliable approach to confirm precise implant alignment.
    • The findings suggest this method can enhance surgical precision and potentially improve TKA outcomes.