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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Do modern total knee replacements improve tibial coverage?

Malin Meier1, Jonathan Webb2, Jamie E Collins3

  • 1University of Ulm, Helmholzstraße 16, 89081, Ulm, Germany.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|January 27, 2018
PubMed
Summary
This summary is machine-generated.

Tibial component coverage in total knee arthroplasty is similar for symmetric and asymmetric designs. Optimal bone coverage depends on the chosen rotational landmark and placement between the medial 1/3 tibial tubercle axis and the medio-lateral axis.

Keywords:
Rotational alignmentTibial coverageTibial rotationTotal knee arthroplastyTotal knee replacement

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Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering
  • Medical imaging

Background:

  • Accurate rotational alignment of tibial components is crucial for successful total knee arthroplasty (TKA).
  • Existing literature lacks consensus on optimal rotational landmarks for maximizing tibial bone coverage.
  • Both symmetric and asymmetric tibial designs are utilized, each with potential benefits for bone coverage.

Purpose of the Study:

  • To compare bone coverage of novel symmetric and asymmetric tibial components.
  • To evaluate coverage within the rotational safe zone defined by two common anatomic landmarks.
  • To quantify cancellous and cortical bone coverage using computed tomography (CT) scans.

Main Methods:

  • CT scans from 100 TKA patients were analyzed.
  • Virtual tibial cuts and superimposition of various implant designs were performed.
  • Cancellous and cortical bone coverage were computed based on rotational alignment relative to the medio-lateral (ML) axis and medial 1/3 tibial tubercle axis.

Main Results:

  • No single implant design consistently provided optimal coverage across all rotational alignments.
  • Tibial bone coverage was significantly influenced by the choice of rotational landmark (ML-axis vs. med-1/3-axis).
  • Optimizing implant placement between the two rotational axes improved bone coverage.

Conclusions:

  • Tibial coverage is comparable between symmetric and asymmetric designs.
  • The choice of rotational landmark is critical for achieving adequate bone coverage.
  • Surgeons can enhance tibial coverage by optimizing rotational placement between the medial 1/3 and ML axes, ensuring proper patella tracking.