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27.10.2019 | Review

Methods of intra- and post-operative determination of the position of the tibial component during total knee replacement

verfasst von: Roman Popescu, Emil G. Haritinian, Stefan Cristea

Erschienen in: International Orthopaedics

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Abstract

Aim of the study

To identify the most reliable anatomical landmarks and imaging techniques for assessing the rotation of the tibial component in total knee arthroplasty (TKA).

Methods

An extensive literature review (from January 2016 to March 2019) was performed. We included studies about primary TKA with details concerning the anatomical landmarks used for implanting the tibial component and also imaging studies assessing tibial component rotation. The final selection comprises only thirty-five articles consistent with the inclusion criteria.

Results

Extra-articular landmarks are not always reliable (even though the tibial tubercle is one of the most popular extra-articular landmarks used to assess the rotation of the tibial component), mainly because they vary and can lead to malrotation of the tibial component. Akagi’s line (an intra-articular landmark) is considered to be the most reliable and easy to find during surgery and likewise is not affected by articular deformities. The anterior tibial cortex (intra-articular landmark) also proved to be accurate and reliable with the main advantage being that is palpable after tibial resection.

Radiography provides a good and inexpensive option for imaging, but it is insufficient. Magnetic resonance imaging (MRI) is used in some cases but not routinely for assessing TKA components or their orientation. Computed tomography (CT), used together with a well-defined protocol (Berger’s method being the preferred choice), remains the “gold standard” for evaluating the rotation of the tibial component after TKA.

Conclusion

Currently, the most accurate and reliable anatomical landmarks are represented by Akagi’s line and the anterior cortex of the tibia. Post-operatively, through CT and well-established protocols, the rotation of the tibial component can be accurately determined.

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Titel: Methods of intra- and post-operative determination of the position of the tibial component during total knee replacement
verfasst von: Roman Popescu
Emil G. Haritinian
Stefan Cristea
Publikationsdatum: 27.10.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-019-04424-9

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Methods of intra- and post-operative determination of the position of the tibial component during total knee replacement

Abstract

Aim of the study

Methods

Results

Conclusion

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Abstract

Aim of the study

Methods

Results

Conclusion

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Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger

Zwei neue Alternativen zu TNF-Inhibitoren bei axSpA

Diclofenac-Gel versus Ibuprofen bei akuten Rückenschmerzen

Update Orthopädie und Unfallchirurgie