Specific tibial landmarks to improve to accuracy of the tibial cut during total knee arthroplasty. A case control study.
Alignment
Anatomical landmarks
Coronal alignment
Total knee arthroplasty
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
05 Jul 2024
05 Jul 2024
Historique:
received:
28
12
2023
accepted:
26
06
2024
medline:
5
7
2024
pubmed:
5
7
2024
entrez:
5
7
2024
Statut:
aheadofprint
Résumé
More personalized alignment techniques in total knee arthroplasty (TKA) have recently been described particularly for the young and active patients. Performing the ideal tibial cut might be challenging with a conventional ancillary. Therefore the aims of this study were: (1) to describe specific tibial landmarks to optimize the tibial cut in TKA; (2) to compare the accuracy of the tibial cut with these landmarks compared to a conventional technique. This retrospective case-control study compared primary TKAs performed using a conventional technique with extramedullary guide associated with specific tibial landmarks. For each case, one control patient was matched based on body mass index (BMI), age, preoperative Hip Knee Ankle (HKA) angle, and Medial Proximal Tibial Angle (MPTA). All control patients were operated by the same surgeon and similar conventional technique but without landmarks. The MPTA target was to reproduce preoperative deformity with a 3° of varus limit. 34 TKA were included in each group. There was no preoperative difference between both groups. Mean age was 63 years old ± 8. Mean BMI was 32 kg/m2 ± 5. Mean HKA was 170.6° ± 2.5. Mean MPTA was 85.1° ± 2.3. The radiographic assessment was performed preoperatively and at 2 months: HKA, mechanical Medial Distal Femoral Angle (mMDFA), MPTA, tibial slope, restoration of the joint line-height. The tibial landmarks corresponded to the line of insertion of the deep medial collateral ligament fibers extended to the capsular insertion above the Gerdy tubercle. The postoperative MPTA was significantly more varus (87.2° ± 1.6 in landmark group versus 88.3° ± 2.2; p = 0.027) and closer to preoperative bone deformity in landmark group (p = 0.002) with significantly less outliers than in the conventional group. There was no significant difference between both groups postoperatively for HKA (175.4° ± 2.3 versus 175.9° ± 2.5; p = 0.42); mMDFA (88.9° ± 2.3 versus 88.2° ± 2.1; p = 0.18); tibial slope (82.6° ± 1.9 versus 82.4° ± 2.6; p = 0.67), the restoration of the joint line-height (1.5 mm ± 2 versus 1.8 mm ± 2; p = 0.56). Specific tibial landmarks during TKA can be used to increase the accuracy of the tibial cut when using personalized alignment techniques in TKA. IV.
Identifiants
pubmed: 38967776
doi: 10.1007/s00402-024-05428-w
pii: 10.1007/s00402-024-05428-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Tew M, Waugh W (1985) Tibiofemoral alignment and the results of knee replacement. J Bone Joint Surg Br 67(4):551–556. https://doi.org/10.1302/0301-620X.67B4.4030849
doi: 10.1302/0301-620X.67B4.4030849
pubmed: 4030849
Fang DM, Ritter MA, Davis KE (2009) Coronal alignment in total knee arthroplasty: just how important is it? J Arthroplasty 24(6 Suppl):39–43. https://doi.org/10.1016/j.arth.2009.04.034
doi: 10.1016/j.arth.2009.04.034
pubmed: 19553073
Palanisami D, Jagdishbhai CP, Manohar M, Ramesh P, Natesan R, Shanmuganathan R (2019) Improving the accuracy of tibial component placement during total knee replacement in varus knees with tibial bowing: a prospective randomised controlled study. Knee 26(5):1088–1095. https://doi.org/10.1016/j.knee.2019.05.010
doi: 10.1016/j.knee.2019.05.010
pubmed: 31375444
Schneider M, Heisel C, Aldinger PR, Breusch SJ (2007) Use of palpable tendons for extramedullary tibial alignment in total knee arthroplasty. J Arthroplasty 22(2):219–226. https://doi.org/10.1016/j.arth.2006.04.023
doi: 10.1016/j.arth.2006.04.023
pubmed: 17275637
Rajadhyaksha AD, Mehta H, Zelicof SB (2009) Use of tibialis anterior tendon as distal landmark for extramedullary tibial alignment in total knee arthroplasty: an anatomical study. Am J Orthop (Belle Mead NJ) 38(3):E68–E70
pubmed: 19377655
Sugimura N, Ikeuchi M, Izumi M, Aso K, Ushida T, Tani T (2014) The dorsal pedis artery as a new distal landmark for extramedullary tibial alignment in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22(11):2618–2622. https://doi.org/10.1007/s00167-013-2461-8
doi: 10.1007/s00167-013-2461-8
pubmed: 23455389
Mizu-Uchi H, Kido H, Chikama T, Kamo K, Kido S, Nakashima Y (2022) The adjustment of the rotational alignment of the distal end of the extramedullary guide to the anteroposterior axis of the proximal tibia in total knee arthroplasty. J Knee Surg 35(12):1273–1279. https://doi.org/10.1055/s-0040-1722660
doi: 10.1055/s-0040-1722660
pubmed: 33511586
Nishikawa K, Mizu-uchi H, Okazaki K, Matsuda S, Tashiro Y, Iwamoto Y (2015) Accuracy of proximal tibial bone cut using anterior border of tibia as bony landmark in total knee arthroplasty. J Arthroplasty 30(12):2121–2124. https://doi.org/10.1016/j.arth.2015.06.055
doi: 10.1016/j.arth.2015.06.055
pubmed: 26233701
Dalury DF (2001) Observations of the proximal tibia in total knee arthroplasty. Clin Orthop Relat Res 389:150–155. https://doi.org/10.1097/00003086-200108000-00021
doi: 10.1097/00003086-200108000-00021
Howell SM, Akhtar M, Nedopil AJ, Hull ML (2024) Reoperation, implant survival, and clinical outcome after kinematically aligned total knee arthroplasty: a concise clinical follow-up at 16 years. J Arthroplasty. 39(3):695–700. https://doi.org/10.1016/j.arth.2023.08.080
doi: 10.1016/j.arth.2023.08.080
pubmed: 37659680
Blakeney W, Beaulieu Y, Kiss MO, Riviere C, Vendittoli PA (2019) Less gap imbalance with restricted kinematic alignment than with mechanically aligned total knee arthroplasty: simulations on 3-D bone models created from CT-scans. Acta Orthop 90(6):602–609. https://doi.org/10.1080/17453674.2019.1675126
doi: 10.1080/17453674.2019.1675126
pubmed: 31610681
pmcid: 6844385
Winnock de Grave P, Kellens J, Tampere T, Vermue H, Luyckx T, Claeys K (2023) Clinical outcomes in TKA are enhanced by both robotic assistance and patient specific alignment: a comparative trial in 120 patients. Arch Orthop Trauma Surg 143(6):3391–9. https://doi.org/10.1007/s00402-022-04636-6
Kayani B, Fontalis A, Haddad IC, Donovan C, Rajput V, Haddad FS (2023) Robotic-arm assisted total knee arthroplasty is associated with comparable functional outcomes but improved forgotten joint scores compared with conventional manual total knee arthroplasty at five-year follow-up. Knee Surg Sports Traumatol Arthroscopy. 31(12):5453–5462. https://doi.org/10.1007/s00167-023-07578-7
doi: 10.1007/s00167-023-07578-7
Parratte S, Van Overschelde P, Bandi M, Ozturk BY, Batailler C (2023) An anatomo-functional implant positioning technique with robotic assistance for primary TKA allows the restoration of the native knee alignment and a natural functional ligament pattern, with a faster recovery at 6 months compared to an adjusted mechanical technique. Knee Surg Sports Traumatol Arthrosc 31(4):1334–46. https://doi.org/10.1007/s00167-022-06995-4
doi: 10.1007/s00167-022-06995-4
pubmed: 35552475
Laddha M, Gaurav S (2021) Assessment of limb alignment and component placement after all burr robotic-assisted TKA. Indian J Orthop 55(Suppl 1):69–75. https://doi.org/10.1007/s43465-020-00269-2.1
doi: 10.1007/s43465-020-00269-2.1
pubmed: 34122757
Parratte Sébastien, Daxhelet Jeremy, Argenson Jean-Noel, Batailler Cécile (2023) The deep-MCL line: a reliable anatomical landmark to optimize the Tibial cut in UKA. J Pers Med. 13(5):855. https://doi.org/10.3390/jpm13050855
doi: 10.3390/jpm13050855
pubmed: 37241025
pmcid: 10222460
Cooke TD (2002) Definition of axial alignment of the lower extremity. J Bone Joint Surg Am 84(1):146–147. https://doi.org/10.2106/00004623-200201000-00027
doi: 10.2106/00004623-200201000-00027
pubmed: 11792796
Cooke TD, Scudamore RA, Bryant JT, Sorbie C, Siu D, Fisher B (1991) A quantitative approach to radiography of the lower limb. Principles and applications. J Bone Joint Surg Br. 73(5):715–720. https://doi.org/10.1302/0301-620X.73B5.1894656
doi: 10.1302/0301-620X.73B5.1894656
pubmed: 1894656
Hofmann AA, Kurtin SM, Lyons S, Tanner AM, Bolognesi MP (2006) Clinical and radiographic analysis of accurate restoration of the joint line in revision total knee arthroplasty. J Arthroplasty 21(8):1154–1162. https://doi.org/10.1016/j.arth.2005.10.026
doi: 10.1016/j.arth.2005.10.026
pubmed: 17162175
Havet E, Gabrion A, Leiber-Wackenheim F, Vernois J, Olory B, Mertl P (2007) Radiological study of the knee joint line position measured from the Wbular head and proximal tibial landmarks. Surg Radiol Anat 29(4):285–289. https://doi.org/10.1007/s00276-007-0207-3
doi: 10.1007/s00276-007-0207-3
pubmed: 17440678
Regier DA, Narrow WE, Clarke DE et al (2013) DSM-5 field trials in the United States and Canada, Part II: test-retest reliability of selected categorical diagnoses. Am J Psychiatry 170(1):59–70. https://doi.org/10.1176/appi.ajp.2012.12070999
doi: 10.1176/appi.ajp.2012.12070999
pubmed: 23111466
Sugimura N, Ozaki K, Aso K, Ikeuchi M (2023) Precision of the ultrasonography-integrated tibial extramedullary guide for total knee arthroplasty. Eur J Orthop Surg Traumatol. https://doi.org/10.1007/s00590-023-03741-5
doi: 10.1007/s00590-023-03741-5
pubmed: 37787971
Reed M, Bliss W, Sher J, Emmerson K, Jones S, Partington P (2002) Extramedullary or intramedullary tibial alignment guides: a randomised, prospective trial of radiological alignment. J Bone Joint Surg Br 84(6):858–860
doi: 10.1302/0301-620X.84B6.0840858
pubmed: 12211678
Zeng HB, Ying XZ, Chen GJ et al (2015) Extramedullary versus intramedullary tibial alignment technique in total knee arthroplasty: a meta-analysis of randomized controlled trials. Clinics (Sao Paulo) 70(10):714–719
doi: 10.6061/clinics/2015(10)10
pubmed: 26598086
Brys DA, Lombardi JA, Mallory TH, Vaughn BK (1991) A comparison of intramedullary and extramedullary alignment systems for tibial component placement in total knee arthroplasty. Clin Orthop Relat Res 263:175–179
doi: 10.1097/00003086-199102000-00020
Razzaghof M, Mortazavi SJ, Moharrami A, Noori A, Tabatabaei IP (2023) The effect of intramedullary vs extramedullary tibial guides on the alignment of lower extremity and functional outcomes following total knee arthroplasty: a randomized clinical trial. Arch Bone Jt Surg 11(7):441–447. https://doi.org/10.22038/ABJS.2022.60061.2960
doi: 10.22038/ABJS.2022.60061.2960
pubmed: 37538133
pmcid: 10394749
Blakeney WG, Khan RJ, Palmer JL (2014) Functional outcomes following total knee arthroplasty: a randomised trial comparing computer-assisted surgery with conventional techniques. Knee 21(2):364–368
doi: 10.1016/j.knee.2013.04.001
pubmed: 24703685
Zhao J, Zhang J, Ji X, Li X, Qian Q, Xu Q (2015) Does intramedullary canal irrigation reduce fat emboli? A randomized clinical trial with transesophageal echocardiography. J Arthroplasty 30(3):451–455. https://doi.org/10.1016/j.arth.2014.10.006
doi: 10.1016/j.arth.2014.10.006
pubmed: 25458091
Strahovnik A, Strahovnik I, Fokter SK (2024) Coronal knee alignment and tibial rotation in total knee arthroplasty: a prospective cohort study of patients with end-stage osteoarthritis. Bioengineering (Basel) 11(3):296. https://doi.org/10.3390/bioengineering11030296
doi: 10.3390/bioengineering11030296
pubmed: 38534570
Lustig S, Sappey-Marinier E, Fary C, Servien E, Parratte S, Batailler C (2021) Personalized alignment in total knee arthroplasty: current concepts. SICOT J. 7:19. https://doi.org/10.1051/sicotj/2021021
doi: 10.1051/sicotj/2021021
pubmed: 33812467
pmcid: 8019550
Sicat CS, Chow JC, Kaper B, Mitra R, Xie J, Schwarzkopf R (2021) Component placement accuracy in two generations of handheld robotics-assisted knee arthroplasty. Arch Orthop Trauma Surg 141(12):2059–2067. https://doi.org/10.1007/s00402-021-04040-6
doi: 10.1007/s00402-021-04040-6
pubmed: 34304279
Chen Z, Bhowmik-Stoker M, Palmer M, Coppolecchia A, Harder B, Mont MA, Marchand RC (2023) Time-based learning curve for robotic-assisted total knee arthroplasty: a multicenter study. J Knee Surg 36(8):873–877. https://doi.org/10.1055/s-0042-1744193
doi: 10.1055/s-0042-1744193
pubmed: 35255506