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A proposed new rotating reference axis for the tibial component after proximal tibial resection in total knee arthroplasty
PURPOSE: During total knee arthroplasty, few rotating reference axes can be reliably used after tibial resection. We speculated that a line that passes through the lateral edge of the posterior cruciate ligament (PCL) at its tibial attachment after resection and the most prominent point of the tibia...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301685/ https://www.ncbi.nlm.nih.gov/pubmed/30571784 http://dx.doi.org/10.1371/journal.pone.0209317 |
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author | Ohmori, Takaaki Kabata, Tamon Kajino, Yoshitomo Inoue, Daisuke Taga, Tadashi Yamamoto, Takashi Takagi, Tomoharu Yoshitani, Junya Ueno, Takuro Ueoka, Ken Tsuchiya, Hiroyuki |
author_facet | Ohmori, Takaaki Kabata, Tamon Kajino, Yoshitomo Inoue, Daisuke Taga, Tadashi Yamamoto, Takashi Takagi, Tomoharu Yoshitani, Junya Ueno, Takuro Ueoka, Ken Tsuchiya, Hiroyuki |
author_sort | Ohmori, Takaaki |
collection | PubMed |
description | PURPOSE: During total knee arthroplasty, few rotating reference axes can be reliably used after tibial resection. We speculated that a line that passes through the lateral edge of the posterior cruciate ligament (PCL) at its tibial attachment after resection and the most prominent point of the tibial tubercle [after-tibial resection (ATR) line] will provide a good reference axis. In this study, we aimed to evaluate the association between ATR and Akagi’s lines. MATERIALS AND METHODS: In this case–control simulation study, we retrospectively evaluated 38 patients with varus knee and 28 patients with valgus knee. We defined the reference cutting plane as 10 mm distal from the lateral articular surface of the tibia in varus group and as 7 mm distal from the medial articular surface in the valgus group. We measured angles between Akagi’s line and the ATR line (ATR line angle) as well as between Akagi’s line and 1/3 Akagi’s line (1/3 Akagi’s line angle), which passes through the midpoint of PCL and the medial third of the patellar tendon. We used paired t-tests to determine the significance of differences between these angles, with p < 0.05 indicating statistical significance. Intra- and interclass correlation coefficients for the reproducibility of 1/3 Akagi’s line angle and ATR line angle were analyzed by two surgeons. RESULTS: We found that 1/3 Akagi’s line angle was 10.2° ± 1.3° in the varus group and 10.9° ± 1.3° in the valgus group (p = 0.017). The ATR line was positioned externally compared with Akagi’s line in all patients. Mean ATR line angles at 0°, 3° and 7° posterior slopes were 6.1° ± 1.9°, 5.8° ± 2.0° and 6.0° ± 1.7° in the varus group and 6.3° ± 2.3°, 6.2° ± 2.3° and 5.4° ± 2.1° in the valgus group, respectively. There were no significant differences in the ATR line angle between the varus and valgus groups. (p = 0.34–0.67) Intra- and interclass correlation coefficients for the reproducibility of 1/3 Akagi’s line angle were 0.936 and 0.986 and those for the reproducibility of ATR line angle were 0.811 and 0.839. CONCLUSIONS: The ATR line was positioned between Akagi’s line and 1/3 Akagi’s line in all patients and was a valid option for evaluating rotational tibial alignment after tibial resection. |
format | Online Article Text |
id | pubmed-6301685 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-63016852019-01-08 A proposed new rotating reference axis for the tibial component after proximal tibial resection in total knee arthroplasty Ohmori, Takaaki Kabata, Tamon Kajino, Yoshitomo Inoue, Daisuke Taga, Tadashi Yamamoto, Takashi Takagi, Tomoharu Yoshitani, Junya Ueno, Takuro Ueoka, Ken Tsuchiya, Hiroyuki PLoS One Research Article PURPOSE: During total knee arthroplasty, few rotating reference axes can be reliably used after tibial resection. We speculated that a line that passes through the lateral edge of the posterior cruciate ligament (PCL) at its tibial attachment after resection and the most prominent point of the tibial tubercle [after-tibial resection (ATR) line] will provide a good reference axis. In this study, we aimed to evaluate the association between ATR and Akagi’s lines. MATERIALS AND METHODS: In this case–control simulation study, we retrospectively evaluated 38 patients with varus knee and 28 patients with valgus knee. We defined the reference cutting plane as 10 mm distal from the lateral articular surface of the tibia in varus group and as 7 mm distal from the medial articular surface in the valgus group. We measured angles between Akagi’s line and the ATR line (ATR line angle) as well as between Akagi’s line and 1/3 Akagi’s line (1/3 Akagi’s line angle), which passes through the midpoint of PCL and the medial third of the patellar tendon. We used paired t-tests to determine the significance of differences between these angles, with p < 0.05 indicating statistical significance. Intra- and interclass correlation coefficients for the reproducibility of 1/3 Akagi’s line angle and ATR line angle were analyzed by two surgeons. RESULTS: We found that 1/3 Akagi’s line angle was 10.2° ± 1.3° in the varus group and 10.9° ± 1.3° in the valgus group (p = 0.017). The ATR line was positioned externally compared with Akagi’s line in all patients. Mean ATR line angles at 0°, 3° and 7° posterior slopes were 6.1° ± 1.9°, 5.8° ± 2.0° and 6.0° ± 1.7° in the varus group and 6.3° ± 2.3°, 6.2° ± 2.3° and 5.4° ± 2.1° in the valgus group, respectively. There were no significant differences in the ATR line angle between the varus and valgus groups. (p = 0.34–0.67) Intra- and interclass correlation coefficients for the reproducibility of 1/3 Akagi’s line angle were 0.936 and 0.986 and those for the reproducibility of ATR line angle were 0.811 and 0.839. CONCLUSIONS: The ATR line was positioned between Akagi’s line and 1/3 Akagi’s line in all patients and was a valid option for evaluating rotational tibial alignment after tibial resection. Public Library of Science 2018-12-20 /pmc/articles/PMC6301685/ /pubmed/30571784 http://dx.doi.org/10.1371/journal.pone.0209317 Text en © 2018 Ohmori et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Ohmori, Takaaki Kabata, Tamon Kajino, Yoshitomo Inoue, Daisuke Taga, Tadashi Yamamoto, Takashi Takagi, Tomoharu Yoshitani, Junya Ueno, Takuro Ueoka, Ken Tsuchiya, Hiroyuki A proposed new rotating reference axis for the tibial component after proximal tibial resection in total knee arthroplasty |
title | A proposed new rotating reference axis for the tibial component after proximal tibial resection in total knee arthroplasty |
title_full | A proposed new rotating reference axis for the tibial component after proximal tibial resection in total knee arthroplasty |
title_fullStr | A proposed new rotating reference axis for the tibial component after proximal tibial resection in total knee arthroplasty |
title_full_unstemmed | A proposed new rotating reference axis for the tibial component after proximal tibial resection in total knee arthroplasty |
title_short | A proposed new rotating reference axis for the tibial component after proximal tibial resection in total knee arthroplasty |
title_sort | proposed new rotating reference axis for the tibial component after proximal tibial resection in total knee arthroplasty |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301685/ https://www.ncbi.nlm.nih.gov/pubmed/30571784 http://dx.doi.org/10.1371/journal.pone.0209317 |
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