Tibial crest alignment technique-an effective technique to improve coronal alignment of tibial component in tka for arthritic knees

INTRODUCTION: Long term survivorship in Total Knee Arthroplasty is significantly dependent on prosthesis alignment.Accuracy of component positioning relies on alignment guides for making precise and accurate bone cuts. HYPOTHESES: The aim of this study was to determine, compare and analyse the coronal alignment of the tibial component of a single implant system using 3 different techniques. METHODS: Retrospective study of cases from a prospectively collected database. Radiological assessment included measurement of the coronal alignment of tibial components of total knee arthroplasties, and its deviation from the mechanical axis. A comparison study of intramedullary, extramedullary and tibial crest alignment methods was performed. RESULTS: 66 consecutive patients (3 groups of 22 each). Mean BMI was 26. The mean angle of deviation from the mechanical axis was significantly lesser (p< 0.05) in the Tibial crest alignment group patients compared to the other 2 groups. Moreover, the number of outliers (+/-3 degrees) were 2 and 4 in the intra and extramedullary group, whereas there were none in the tibial crest group. The inter and intraclass correlation coefficient was 0.8 and 0.9 respectively. CONCLUSION: The Tibial Crest Alignment Technique is an effective technique to produce consistent results to achieve optimal coronal alignment of the tibial component in TKA, even in patients with high BMI.