Reliability of Intra-articular Rotational Axes at Standard Tibial Resection Level and Effect of Resecting Distally

Yoshvin Sunnassee; Henghui Zhang; Edward P. Southern; Yi Wang; Yuhui Shen

doi:10.1055/s-0034-1378193

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2015; 28(03): 223-228
DOI: 10.1055/s-0034-1378193

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Reliability of Intra-articular Rotational Axes at Standard Tibial Resection Level and Effect of Resecting Distally

Yoshvin Sunnassee

¹Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai, People's Republic of China

²School of Medicine, Shanghai Institute of Orthopedics and Traumatology, Shanghai Jiao Tong University, Shanghai, People's Republic of China

,

Henghui Zhang

¹Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai, People's Republic of China

²School of Medicine, Shanghai Institute of Orthopedics and Traumatology, Shanghai Jiao Tong University, Shanghai, People's Republic of China

,

Edward P. Southern

³Department of Orthopedics Surgery, Louisiana State University Health Science Center, New Orleans, Louisiana

⁴Institute for Western Surgery, Shanghai, People's Republic of China

,

Yi Wang

¹Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai, People's Republic of China

²School of Medicine, Shanghai Institute of Orthopedics and Traumatology, Shanghai Jiao Tong University, Shanghai, People's Republic of China

,

Yuhui Shen

¹Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai, People's Republic of China

²School of Medicine, Shanghai Institute of Orthopedics and Traumatology, Shanghai Jiao Tong University, Shanghai, People's Republic of China

› Author Affiliations

Abstract

We determine the most reliable tibial intra-articular axis for rotational alignment of the tibial component at the standard resection level and at a distal resection level. The angles between the surgical transepicondylar axis and posterior condylar line, perpendicular to Akagi line, tibial anterior condylar line (ACL), and tibial maximum mediolateral line were measured at the standard resection level and 5 mm distal to the standard resection level. All axes exhibited relatively large standard deviations and ranges at the standard and distal resection level. t-test showed that there was a statistically significant difference (p < 0.05) for all the axes between the two resection levels, while only ACL showed a statistically significant difference (p = 0.047) with the equality of variance F-test. Akagi line exhibited good interobserver and intraobserver reliabilities but must be used with caution. Intra-articular axes are not reliable for tibial component alignment.

Keywords

total knee arthroplasty - tibial component - rotational alignment

Full Text

References

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