Simple method for confirming tibial osteotomy during total knee arthroplasty.

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.
• 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.