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Accuracy of the Tibial Component Alignment by Extramedullary System Using Simple Radiographic References in Total
Jin-Ho Cho1, Jun Young Choi1, Sung-Sahn Lee1
1Department of Orthopedic Surgery, Ilsan Paik Hospital, Inje University School of Medicine, Goyang-si 10380, Korea.
Medicina (Kaunas, Lithuania)
|September 23, 2022
Summary
Pre-operative tibial measurements and intraoperative C-arm guidance improve tibial component alignment in total knee arthroplasty (TKA), especially for severe varus knees. This technique helps achieve optimal coronal positioning and enhances TKA longevity.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Tibial component alignment is critical for total knee arthroplasty (TKA) longevity.
- Accurate tibial cuts are essential, particularly in varus knees.
Purpose of the Study:
- To evaluate the utility of pre-operative tibial radiography and intraoperative C-arm guided hip and ankle center marking.
- To assess these methods for extramedullary guided tibial cuts in mild and severe varus TKA.
Main Methods:
- Retrospective review of 220 TKAs (150 patients) from July 2011 to April 2017.
- Pre-operative identification of tibial reference points and cut thickness.
- Intraoperative C-arm confirmation of hip and ankle centers.
Main Results:
- Significant improvement in hip-knee-ankle (HKA) alignment post-surgery (p < 0.001).
- Average tibial component angle was 90.1°.
- Outlier rates were 9.5% for HKA alignment and 1.4% for medial proximal tibial angle (MPTA).
Conclusions:
- Pre-operative tibial radiographic references are useful.
- Intraoperative C-arm guidance for hip and ankle centers aids favorable tibial component coronal positioning.
- These combined techniques support accurate extramedullary guided tibial cuts in TKA.
