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Fibular axes are not a reliable landmark for tibial mechanical axes of osteoarthritic knees that underwent total knee arthroplasty

Knee Surgery, Sports Traumatology, Arthroscopy volume 23, pages 3362–3367 (2015)Cite this article

Abstract

Purpose

The sagittal fibular axis serves as an intra-operative landmark during conventional total knee arthroplasty (TKA); however, only a few relevant anatomical studies have been published regarding its use as an extramedullary guide. Furthermore, the correlation between the coronal fibular and tibial mechanical axes in osteoarthritic knees has been only reported once. Here, the hypothesis of this study is that the fibula can be a reliable intra-operative landmark, in the sagittal and coronal planes, among patients with osteoarthritis who have undergone TKA.

Methods

Osteoarthritic knees (n = 62) after TKA were evaluated using three-dimensional image-matching software. The angles between the tibial mechanical axis and the fibular shaft axis were measured in the sagittal and coronal planes. Moreover, correlations between the angles and patient-specific factors were evaluated.

Results

The mean angle between the tibial mechanical and fibular shaft axes was 2.6° ± 2.3° for posterior inclination in the sagittal plane and 0.9° ± 2.0° for varus inclination in the coronal plane. The percentage of subjects with the fibular shaft axis within 2° of the tibial mechanical axis was 17.7 and 69.3 % in the sagittal and coronal planes, respectively. No patient-specific factors were correlated with the angle between the tibial mechanical and fibular shaft axes.

Conclusions

The angle between the tibial mechanical and fibular shaft axes differed among patients, independent of patient-specific factors, and did not appear to be a reliable intra-operative landmark. Surgeons should use values from individual pre-operative evaluations of the axis as reference for conventional TKA.

Level of evidence

Case series with no comparison group, Level IV.

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Affiliations

  1. Department of Orthopaedic Surgery, Hyogo Rehabilitation Center Hospital, Kobe, Japan

    Yuichi Kuroda & Nobuhiro Tsumura

  2. Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 3-11-15, Shinohara-Kita, Nada, Kobe, 657-0068, Japan

    Kazunari Ishida & Hiroshi Sasaki

  3. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

    Tomoyuki Matsumoto, Tokio Matsuzaki, Shinya Oka, Koji Takayama, Takehiko Matsushita, Ryosuke Kuroda & Masahiro Kurosaka

  4. Department of Orthopaedic Surgery, Chibune General Hospital, Osaka, Japan

    Katsumasa Tei

Authors
  1. Yuichi Kuroda
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  2. Kazunari Ishida
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  3. Tomoyuki Matsumoto
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  4. Hiroshi Sasaki
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  5. Tokio Matsuzaki
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  6. Shinya Oka
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  7. Koji Takayama
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  8. Katsumasa Tei
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  9. Takehiko Matsushita
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  10. Nobuhiro Tsumura
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  11. Ryosuke Kuroda
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  12. Masahiro Kurosaka
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Correspondence to Kazunari Ishida.

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Kuroda, Y., Ishida, K., Matsumoto, T. et al. Fibular axes are not a reliable landmark for tibial mechanical axes of osteoarthritic knees that underwent total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 23, 3362–3367 (2015). https://doi.org/10.1007/s00167-014-3170-7

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  • DOI: https://doi.org/10.1007/s00167-014-3170-7

Keywords

  • Total knee arthroplasty
  • Fibula axis
  • Surgical technique
  • Anatomical landmark
  • Tibial slope