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Related Concept Videos

Knee Joint01:23

Knee Joint

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The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...
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Related Experiment Video

Updated: Apr 23, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Improving tibial component alignment in total knee arthroplasty.

G Cinotti1, P Sessa2, A D'Arino2

  • 1Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, University "La Sapienza", Rome, Italy. md3581@mclink.it.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|September 15, 2014
PubMed
Summary
This summary is machine-generated.

A modified surgical technique for total knee arthroplasty (TKA) improved tibial component alignment by referencing the proximal tibia, reducing malalignment caused by tibial torsion.

Keywords:
Extramedullary instrumentationsTibial component alignmentTibial cutTotal knee alignmentTotal knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering
  • Medical Device Technology

Background:

  • Tibial torsion can impact the accuracy of extramedullary instrumentation in total knee arthroplasty (TKA).
  • Accurate component alignment is crucial for optimal TKA outcomes.
  • Standard surgical techniques may not adequately address rotational deformities like tibial torsion.

Purpose of the Study:

  • To evaluate a modified surgical technique for TKA that aligns the extramedullary rod to proximal tibial reference points only.
  • To determine if this technique can overcome the influence of tibial torsion on component alignment.
  • To compare the accuracy of tibial component alignment between the modified technique and a standard procedure.

Main Methods:

  • A consecutive series of 94 TKAs were analyzed.
  • Group 1 (n=47) underwent standard tibial component alignment.
  • Group 2 (n=47) used a modified technique aligning the extramedullary rod to proximal tibia references only.
  • Postoperative long-leg radiographs assessed lower limb, femoral, and tibial component alignment.

Main Results:

  • No significant differences in femorotibial mechanical axes or femoral component alignment between groups.
  • Neutral tibial component alignment was achieved in 34% of knees in group 2 versus 17% in group 1 (p=0.04).
  • Malalignment >3° was significantly reduced in group 2 (4%) compared to group 1 (34%) (p=0.0001).

Conclusions:

  • Aligning the extramedullary rod to proximal tibial references improves coronal tibial component alignment in TKA.
  • This modified technique effectively bypasses the distorting effect of tibial torsion on distal tibial alignment.
  • The technique offers a potential method to reduce tibial component malalignment rates in TKA.