The anatomical tibial axis: reliable rotational orientation in knee replacement.

@article{Cobb2008TheAT,
  title={The anatomical tibial axis: reliable rotational orientation in knee replacement.},
  author={Justin P. Cobb and Hannah Dixon and Wael Dandachli and Farhad Golshan Iranpour},
  journal={The Journal of bone and joint surgery. British volume},
  year={2008},
  volume={90 8},
  pages={
          1032-8
        }
}
  • J. Cobb, H. Dixon, +1 author F. Iranpour
  • Published 1 August 2008
  • Medicine, Biology
  • The Journal of bone and joint surgery. British volume
The rotational alignment of the tibia is an unresolved issue in knee replacement. A poor functional outcome may be due to malrotation of the tibial component. Our aim was to find a reliable method for positioning the tibial component in knee replacement. CT scans of 19 knees were reconstructed in three dimensions and orientated vertically. An axial plane was identified 20 mm below the tibial spines. The centre of each tibial condyle was calculated from ten points taken round the condylar cortex… 
View on PubMed
online.boneandjoint.org.uk
118 Citations
Highly Influential Citations
10
Background Citations
24
Methods Citations
23
Results Citations
3

118 Citations

Citation Type

Citation Type

Rotational Alignment Landmarks in Primary Total Knee Arthroplasty
TLDR
Alignment of the tibial component, when based on the anterior tibIAL surface, was more reliable and easier identifiable than either the Akagi’s line or the medial third of theTibial tubercle.
Using the anatomical tibial axis for total knee arthroplasty alignment may lead to an internal rotation error
TLDR
The aim of this study was to compare the anatomical tibial axis of the physiological tIBial joint surface to the resected one and concluded that using the ATA on the resection surface may contribute to an internal rotation error.
Rotational alignment of the tibial component in total knee arthroplasty: the anterior tibial cortex is a reliable landmark.
TLDR
The anterior tibial surface curvature was found to be a more reliable and more easily identifiable landmark for correct tibIAL component alignment than either Akagi's line or the medial third of the tibiantubercle.
Total knee arthroplasty: posterior tibial slope influences the size but not the rotational alignment of the tibial component
TLDR
Differences in the posterior tibial slope should not contribute to a rotational malalignment when using the ATA to align the prosthetic tibials plateau.
Evaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging
TLDR
The result showed that the rotational alignment led to notable variance between femoral and tibial components using fixed bone landmarks, and surgeons may choose the proper anteroposterior axis of the tibia component in order to reduce rotational mismatch and improve clinical outcomes.
Effects of tibial baseplate shape on rotational alignment in total knee arthroplasty: three-dimensional surgical simulation using osteoarthritis knees
TLDR
Symmetrically or anatomically designed tibial baseplates have their own favored AP axis and specific performance on coverage and will effectively lower the mismatch rates compared to a symmetricallydesigned tibIAL baseplate when aligned to axis 1/3MED.
Improving tibial component alignment in total knee arthroplasty
TLDR
Using this technique, the rate of malalignment of the tibial component may be reduced compared to a standard technique in which a fixed reference is used at the ankle joint.
Effects of tibial torsion on distal alignment of extramedullary instrumentation in total knee arthroplasty
TLDR
To avoid a varus tibial cut in TKA, extramedullary alignment systems should be aligned more medially at the ankle joint than previously thought, due to the effect of tibIAL torsion and—to a lesser extent—to the different malleolar width.
Centre of the posterior cruciate ligament and the sulcus between tubercle spines are reliable landmarks for tibial component placement
TLDR
When the tibial component is aligned using the axis drawn from the centre of the PCL to the sulcus between the t Tibial spines on the proximal tibia and to the tIBialis anterior tendon at the ankle, good alignment will be achieved in both the coronal and axial planes.
Reliability of frames of reference used for tibial component rotation in total knee arthroplasty
TLDR
High variability in the frames of reference used for tibial rotation alignment was found, however, the anterior condylar axis and transverse axis may warrant further tests with the use of navigation.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 39 REFERENCES
Can the epicondylar axis be defined accurately in total knee arthroplasty?
Observations of the Proximal Tibia in Total Knee Arthroplasty
  • D. Dalury
  • Medicine
    Clinical orthopaedics and related research
  • 2001
TLDR
The current study showed that a line drawn 1 mm medial to the medial border of the tibial tubercle and going through the midsulcus of theTibial spines provided a reproducible landmark for the tibia, and when a perpendicular cut was made relative to this line, 46 of 50 knees were cut in appropriate alignment.
An Anteroposterior Axis of the Tibia for Total Knee Arthroplasty
TLDR
The line connecting the middle of the posterior cruciate ligament and the medial border of the attachment may be useful as a reference axis indicating the anteroposterior orientation of the tibia.
The effect of ankle rotation on cutting of the tibia in total knee arthroplasty.
TLDR
When an extramedullary alignment guide is used to prepare the tibia in total knee arthroplasty, varus alignment of the tibial component can occur because of a rotational mismatch between the proximal part of theTibia and the ankle joint.
Medial Torsion of the Tibia in Japanese Patients With Osteoarthritis of the Knee
TLDR
In the treatment specifically of patients from East Asian countries, medial torsion of the tibia should be taken into account in total knee arthroplasty to ensure proper patellar tracking and proper rotation of the foot in knees with medial femorotibial osteoarthritis.
Reliability of the anteroposterior axis and the posterior condylar axis for determining rotational alignment of the femoral component in total knee arthroplasty
  • R. Nagamine, H. Miura, +5 authors Y. Iwamoto
  • Medicine
    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
  • 1998
TLDR
The results demonstrated that the anteroposterior axis was rotated externally to a significant degree in medial FT-OA knees and was less reliable than the posterior condylar axis for use in alignment for TKA on medial FT -OA knees.
Tibial axis and patellar position relative to the femoral epicondylar axis during squatting.
In Vivo Three-Dimensional Patellar Tracking on the Femur
TLDR
In vivo three-dimensional patellar tracking under weightbearing conditions was investigated with the principal reference axes of the femur in the coronal and axial planes, using a biplanar image-matching technique to improve the understanding of patellofemoral kinematics and provide useful information for the design and positioning of the prostheses used in total knee arthroplasty.
A clinical comparison of patellar tracking using the transepicondylar axis and the posterior condylar axis.
Surgical epicondylar axis vs anatomical epicondylar axis for rotational alignment of the femoral component in total knee arthroplasty.
TLDR
The AEpi axis was more reliable for rotational alignment of the femoral component than the SEpi axis, and the SEPI axis, providing less external rotated to the PC axis, may be difficult to define and could cause patellofemoral tracking problems in total knee arthroplasty.
...
1
2
3
4
...