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Accuracy of a proximal tibial cutting method using the anterior tibial border in TKA

European Journal of Orthopaedic Surgery & Traumatology volume 24, pages 1525–1530 (2014)Cite this article

Abstract

Purpose

In conventional total knee arthroplasty (TKA) using extramedullary alignment guides, it is not always easy to cut the proximal tibia precisely perpendicular to the tibial axis. The purpose of this study was to compare the radiographic accuracy of cutting the proximal tibia between the use of the bony landmarks of the anterior tibial border and the use of the conventional technique.

Methods

A total of 173 patients underwent primary TKA. In 76 TKAs, we used the bony landmark method, and in 97 TKAs, we used the conventional method. In the bony landmark method, we set the coronal alignment in reference to the line connecting the proximal and distal one-third of the anterior tibial border, and we determined the 5° posterior slope in reference to this line. Six months postoperatively, radiological evaluations were performed using full-length standing anteroposterior and lateral radiographs of the knee.

Results

No significant differences in the coronal tibial component angle were found between the groups. The posterior tilt of the tibial component was significantly smaller in the bony landmark method than in the conventional method (5.1° ± 2.9° vs. 6.4° ± 3.2°, respectively; p = 0.007). The percentage of patients whose posterior tilt of the tibial component was within ±3° of 5° was significantly larger in the bony landmark method than in the conventional method (70 vs. 62 %, respectively; p = 0.04).

Conclusions

The bony landmark method provided a more accurate posterior tibial slope than the conventional method. However, there was no difference in coronal alignment compared with the conventional method.

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Affiliations

  1. Department of Orthopaedic Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 3290498, Japan

    Hideyuki Sasanuma, Hitoshi Sekiya, Kenzo Takatoku, Takashi Ajiki & Hiroyoshi Hagiwara

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  1. Hideyuki Sasanuma
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  2. Hitoshi Sekiya
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  3. Kenzo Takatoku
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  4. Takashi Ajiki
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  5. Hiroyoshi Hagiwara
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Correspondence to Hideyuki Sasanuma.

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Sasanuma, H., Sekiya, H., Takatoku, K. et al. Accuracy of a proximal tibial cutting method using the anterior tibial border in TKA. Eur J Orthop Surg Traumatol 24, 1525–1530 (2014). https://doi.org/10.1007/s00590-014-1415-2

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  • DOI: https://doi.org/10.1007/s00590-014-1415-2

Keywords

  • Total knee arthroplasty
  • Tibial bone resection
  • Anterior tibial border
  • Extramedullary alignment guide