scholarly journals Radiographic evaluation of tibial component alignment in total knee arthroplasty following extramedullary and intramedullary tibial referencing

2017 ◽  
Vol 3 (6) ◽  
pp. 1199
Author(s):  
B. Harikrishnan ◽  
Anjan Prabhakara ◽  
Gururaj R. Joshi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Radiographic Evaluation ◽  
Component Alignment ◽  
Tibial Component Alignment ◽  
Knee Deformity ◽  
Total Knee ◽  
The Difference

<p class="abstract"><strong>Background:</strong> Long term survivorship of total knee arthroplasty (TKA) is significantly dependant on prostheses alignment. The debate on optimal referencing for femoral component is largely resolved with Intra-medullary jigs reproducing superior alignment. However there is still a contention about whether intramedullary or extramedullary jigs are better for tibial referencing. This study aims to compare the accuracy of tibial component alignment in TKA using intramedullary and extramedullary tibial referencing jigs.</p><p class="abstract"><strong>Methods:</strong> Between December 2012 and September 2014, 66 primary conventional cemented TKAs were performed using Nexgen-LPS Flex (Zimmer) implants in 55 patients, 50-80 y old (mean 65.54 y) with osteoarthritis/rheumatoid arthritis. Intramedullary and extramedullary tibial referencing was used in alternate patients undergoing TKA after excluding patients with BMI <span style="text-decoration: underline;">&gt;</span>35 kg/m<sup>2</sup>, knee deformity <span style="text-decoration: underline;">&gt;</span>15<sup>0</sup>,excessive tibial bowing, previous fractures/surgeries/retained metalwork around knee. Postoperatively, tibial component alignment (TCA) in coronal plane was assessed using AP radiograph of leg. A 3<sup>º</sup> cutoff from neutral mechanical axis (i.e., 90<sup>o</sup>±3<sup>o</sup>) was considered acceptable.<strong></strong></p><p class="abstract"><strong>Results:</strong> The intramedullary group (n=33) had 4 outliers (TCA &gt;93<sup>º</sup> or &lt;87<sup>º</sup>) whereas the extramedullary group (n=33) had 7 outliers (p=0.511). The difference in mean TCA between intramedullary and extramedullary groups was not statistically significant [90.70±2.43 and 90.55±2.17 (p=0.790)]. There were no significant per-operative/post-operative complications in either group.</p><p><strong>Conclusions:</strong> We conclude that both intramedullary and extramedullary tibial referencing guides can be used to achieve desired tibial component alignment (90±3<sup>º</sup>) in TKA. However the surgeon should appreciate the benefits and deficiencies of either types of tibial referencing and use whichever is suited in a particular case. </p>

Improving tibial component alignment in total knee arthroplasty

2014 ◽  
Vol 23 (12) ◽  
pp. 3563-3570 ◽  
Author(s):  
G. Cinotti ◽  
P. Sessa ◽  
A. D’Arino ◽  
F. R. Ripani ◽  
G. Giannicola
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Component Alignment ◽  
Tibial Component Alignment ◽  
Total Knee

Pedobarographic Analysis in Total Knee Arthroplasty

2017 ◽  
Vol 30 (09) ◽  
pp. 951-959 ◽  
Author(s):  
Onur Kocadal ◽  
Budak Akman ◽  
Uğur Şayli ◽  
Faik Altıntaş ◽  
Melih Güven
Keyword(s):  
Total Knee Arthroplasty ◽  
Gait Analysis ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Component Alignment ◽  
Abnormal Gait ◽  
Prosthetic Alignment ◽  
Tibial Component Alignment ◽  
Total Knee ◽  
Component Malposition

AbstractPedobarographic gait analysis is a useful tool for the determination of loading distributions and alterations on the lower extremity and their reflection on the foot sole after many orthopaedic surgical applications. To date, there have been no studies evaluating the relationship between component alignment and changes of pedobarographic gait analysis in total knee arthroplasty (TKA). We aimed to investigate the effects of TKA and prosthetic alignment on the distribution of pedobarographic parameters. Quantitative gait patterns of 47 patients were prospectively evaluated by using pedobarography 1 week before surgery and at the seventh month, on average, postoperatively. Component positions were assessed, and all applications were divided into three groups according to tibial component position as varus, neutral, and valgus. Pedobarographic results were compared between pre- and postoperative values for all applications and compared among the groups. Mean postoperative tibiofemoral angle was 5.4 degrees in valgus, and preoperative knee scores were markedly improved postoperatively. The range of tibial component alignment changed between 1 and 4 degrees in the varus and valgus groups. Plantar loading parameters (force and pressure) were significantly decreased in all operated knees, especially in forefoot and midfoot. In varus tibial components, plantar loading values decreased in midfoot and hindfoot. However, in the neutral and valgus groups, similar alterations of plantar loadings were obtained, which included decreasing in forefoot and midfoot with significant increase in hindfoot. Plantar loading distribution changed statistically significantly after TKA despite good clinical and radiographic results. Tibial component alignment was also responsible for plantar loading distribution. Tibial components in varus position create different foot loading characteristics compared with neutral and valgus aligned components. Pedobarographic evaluation in TKA allows clinicians to obtain a proper understanding of abnormal gait caused by component malposition.

Varus alignment of the tibial component up to seven degrees is not associated with poor long-term outcomes in a neutrally aligned total knee arthroplasty

2021 ◽  
Author(s):  
Francisco Antonio Miralles-Muñoz ◽  
Marta Rubio-Morales ◽  
Laiz Bello-Tejada ◽  
Santiago González-Parreño ◽  
Alejandro Lizaur-Utrilla ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Varus Alignment ◽  
Long Term Outcomes ◽  
Total Knee

scholarly journals Preoperative Radiological Assessment of The Total Knee Arthroplasty

2021 ◽  
Author(s):  
Atilla Hikmet Cilengir ◽  
Suat Dursun ◽  
Kazım Ayberk Sinci ◽  
Özgür Tosun
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Clinical Results ◽  
Preoperative Imaging ◽  
Radiographic Evaluation ◽  
Prosthetic Material ◽  
Total Knee ◽  
Severity Of The Disease ◽  
Implant Alignment

Total knee arthroplasty (TKA) is a surgery method that can reduce symptoms and restore joint functions. Long-term success of this operation depends on the correct anatomical and mechanical planning before the prosthetic material implantation. Accurate implant alignment together with anatomical balance provides more successful clinical outcomes and longer duration of the prosthetic material. Improper preoperative planning may cause implant loosening and increased load on the knee joint. Conventional radiographs are the most frequently used imaging methods for this purpose. Computed tomography and magnetic resonance imaging may be used in required cases. In addition, computer-aided systems have come into use and successful results have been reported. Early radiographic evaluation is unnecessary after an uncomplicated TKA. Preoperative imaging has several aims such as to assess the severity of the disease, to analyze the reserve bone tissue, to review the relevant anatomy, and to decide which implant and surgical approach will be applied. In this article, we aimed to present the necessary and also auxiliary radiological evaluations made before TKA in order to achieve better clinical results.

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