Cargando…
Effects of tibial torsion on distal alignment of extramedullary instrumentation in total knee arthroplasty
BACKGROUND AND PURPOSE: Whether tibial torsion affects the positioning of extramedullary instrumentation and is a possible factor in malalignment of the tibial component in total knee arthroplasty (TKA) is unknown. We assessed the influence of tibial torsion on distal alignment of extramedullary sys...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Informa Healthcare
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3715826/ https://www.ncbi.nlm.nih.gov/pubmed/23594222 http://dx.doi.org/10.3109/17453674.2013.792032 |
_version_ | 1782277509937627136 |
---|---|
author | Cinotti, Gianluca Sessa, Pasquale Rocca, Antonello Della Ripani, Francesca Romana Giannicola, Giuseppe |
author_facet | Cinotti, Gianluca Sessa, Pasquale Rocca, Antonello Della Ripani, Francesca Romana Giannicola, Giuseppe |
author_sort | Cinotti, Gianluca |
collection | PubMed |
description | BACKGROUND AND PURPOSE: Whether tibial torsion affects the positioning of extramedullary instrumentation and is a possible factor in malalignment of the tibial component in total knee arthroplasty (TKA) is unknown. We assessed the influence of tibial torsion on distal alignment of extramedullary systems for TKA, using the center of the intermalleolar distance as anatomical reference at the ankle joint. PATIENTS AND METHODS: We analyzed CT scans of knee and ankle joints of 50 patients with knee osteoarthritis (mean age 73 years, 52 legs). The tibial mechanical axis was identified and translated anteriorly at the level of the medial one-third (proximal AP axis 1), at the medial border of the tibial tuberosity (proximal AP axis 2), and at the level of the talar dome (distal AP axis). The center of the intermalleolar distance and the width of the medial and lateral malleolus were calculated. The proximal AP axes 1 and 2 were translated at the level of the ankle joint and any difference between their alignment and the distal AP axis was calculated as angular and linear values. RESULTS: The center of the ankle joint was located, on average 2 mm medial to that of the intermalleolar distance. The distal AP axis was externally rotated by 18° and 27° compared to the proximal AP axes 1 and 2, respectively. Overall, the center of the ankle joint was shifted laterally by 9–11 mm with respect to the proximal AP tibial axes. INTERPRETATION: 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. |
format | Online Article Text |
id | pubmed-3715826 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Informa Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-37158262013-07-19 Effects of tibial torsion on distal alignment of extramedullary instrumentation in total knee arthroplasty Cinotti, Gianluca Sessa, Pasquale Rocca, Antonello Della Ripani, Francesca Romana Giannicola, Giuseppe Acta Orthop Knee BACKGROUND AND PURPOSE: Whether tibial torsion affects the positioning of extramedullary instrumentation and is a possible factor in malalignment of the tibial component in total knee arthroplasty (TKA) is unknown. We assessed the influence of tibial torsion on distal alignment of extramedullary systems for TKA, using the center of the intermalleolar distance as anatomical reference at the ankle joint. PATIENTS AND METHODS: We analyzed CT scans of knee and ankle joints of 50 patients with knee osteoarthritis (mean age 73 years, 52 legs). The tibial mechanical axis was identified and translated anteriorly at the level of the medial one-third (proximal AP axis 1), at the medial border of the tibial tuberosity (proximal AP axis 2), and at the level of the talar dome (distal AP axis). The center of the intermalleolar distance and the width of the medial and lateral malleolus were calculated. The proximal AP axes 1 and 2 were translated at the level of the ankle joint and any difference between their alignment and the distal AP axis was calculated as angular and linear values. RESULTS: The center of the ankle joint was located, on average 2 mm medial to that of the intermalleolar distance. The distal AP axis was externally rotated by 18° and 27° compared to the proximal AP axes 1 and 2, respectively. Overall, the center of the ankle joint was shifted laterally by 9–11 mm with respect to the proximal AP tibial axes. INTERPRETATION: 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. Informa Healthcare 2013-06 2013-05-31 /pmc/articles/PMC3715826/ /pubmed/23594222 http://dx.doi.org/10.3109/17453674.2013.792032 Text en Copyright: © Nordic Orthopaedic Federation http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited. |
spellingShingle | Knee Cinotti, Gianluca Sessa, Pasquale Rocca, Antonello Della Ripani, Francesca Romana Giannicola, Giuseppe Effects of tibial torsion on distal alignment of extramedullary instrumentation in total knee arthroplasty |
title | Effects of tibial torsion on distal alignment of extramedullary instrumentation in total knee arthroplasty |
title_full | Effects of tibial torsion on distal alignment of extramedullary instrumentation in total knee arthroplasty |
title_fullStr | Effects of tibial torsion on distal alignment of extramedullary instrumentation in total knee arthroplasty |
title_full_unstemmed | Effects of tibial torsion on distal alignment of extramedullary instrumentation in total knee arthroplasty |
title_short | Effects of tibial torsion on distal alignment of extramedullary instrumentation in total knee arthroplasty |
title_sort | effects of tibial torsion on distal alignment of extramedullary instrumentation in total knee arthroplasty |
topic | Knee |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3715826/ https://www.ncbi.nlm.nih.gov/pubmed/23594222 http://dx.doi.org/10.3109/17453674.2013.792032 |
work_keys_str_mv | AT cinottigianluca effectsoftibialtorsionondistalalignmentofextramedullaryinstrumentationintotalkneearthroplasty AT sessapasquale effectsoftibialtorsionondistalalignmentofextramedullaryinstrumentationintotalkneearthroplasty AT roccaantonellodella effectsoftibialtorsionondistalalignmentofextramedullaryinstrumentationintotalkneearthroplasty AT ripanifrancescaromana effectsoftibialtorsionondistalalignmentofextramedullaryinstrumentationintotalkneearthroplasty AT giannicolagiuseppe effectsoftibialtorsionondistalalignmentofextramedullaryinstrumentationintotalkneearthroplasty |