Evaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging

Abstract Surgeon-dependent factors such as optimal implant alignment of the tibial component are thought to play a significant role in the outcome following primary total knee arthroplasty (TKA). In addition, tibial component malrotation is associated with pain, stiffness, and altered patellofemoral...

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Autores principales:	Ji-Hoon Nam, Yong-Gon Koh, Paul Shinil Kim, Gihun Kim, Yoon Hae Kwak, Kyoung-Tak Kang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/37e652de4ec3475fa8a177dac6bcd6a6
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spelling	oai:doaj.org-article:37e652de4ec3475fa8a177dac6bcd6a62021-12-02T16:45:53ZEvaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging10.1038/s41598-020-70851-z2045-2322https://doaj.org/article/37e652de4ec3475fa8a177dac6bcd6a62020-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-70851-zhttps://doaj.org/toc/2045-2322Abstract Surgeon-dependent factors such as optimal implant alignment of the tibial component are thought to play a significant role in the outcome following primary total knee arthroplasty (TKA). In addition, tibial component malrotation is associated with pain, stiffness, and altered patellofemoral kinematics in TKA. However, measuring tibial component rotation after TKA is difficult. Therefore, the purpose of this study was to find a reliable method for positioning the tibial component in TKA. To investigate the morphology of the tibial plateau, 977 patients' knees (829 females and 148 males) were evaluated using MRI. The relationships between the femoral transepicondylar axis (TEA), Akagi line, posterior tibial margin (PTM), medial third of the tibial tubercle (MTT), and anatomical tibial axis (ATS) were investigated in this study. In addition, gender difference in tibial rotational alignment were evaluated. Relative to the TEA, the MTT and ATS were externally rotated by 0.5° ± 4.4° and 0.5° ± 5.4°, respectively, while Akagi line and PTM were internally rotated by 3.7° ± 4.5° and 9.9° ± 6.1°, respectively. Gender differences were found in MTT, Akagi line and ATS (P < 0.05). Our result showed that the rotational alignment led to notable variance between femoral and tibial components using fixed bone landmarks. The MTT and ATS axes showed the closest perpendicular aspect with projected TEA. And the MTT and Akagi axes showed the reduced variance. In addition, PTM is not a reliable landmark for rotation of the tibial component. Based on the results of this study, surgeons may choose the proper anteroposterior axis of the tibial component in order to reduce rotational mismatch and improve clinical outcomes.Ji-Hoon NamYong-Gon KohPaul Shinil KimGihun KimYoon Hae KwakKyoung-Tak KangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-7 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ji-Hoon Nam Yong-Gon Koh Paul Shinil Kim Gihun Kim Yoon Hae Kwak Kyoung-Tak Kang Evaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging
description	Abstract Surgeon-dependent factors such as optimal implant alignment of the tibial component are thought to play a significant role in the outcome following primary total knee arthroplasty (TKA). In addition, tibial component malrotation is associated with pain, stiffness, and altered patellofemoral kinematics in TKA. However, measuring tibial component rotation after TKA is difficult. Therefore, the purpose of this study was to find a reliable method for positioning the tibial component in TKA. To investigate the morphology of the tibial plateau, 977 patients' knees (829 females and 148 males) were evaluated using MRI. The relationships between the femoral transepicondylar axis (TEA), Akagi line, posterior tibial margin (PTM), medial third of the tibial tubercle (MTT), and anatomical tibial axis (ATS) were investigated in this study. In addition, gender difference in tibial rotational alignment were evaluated. Relative to the TEA, the MTT and ATS were externally rotated by 0.5° ± 4.4° and 0.5° ± 5.4°, respectively, while Akagi line and PTM were internally rotated by 3.7° ± 4.5° and 9.9° ± 6.1°, respectively. Gender differences were found in MTT, Akagi line and ATS (P < 0.05). Our result showed that the rotational alignment led to notable variance between femoral and tibial components using fixed bone landmarks. The MTT and ATS axes showed the closest perpendicular aspect with projected TEA. And the MTT and Akagi axes showed the reduced variance. In addition, PTM is not a reliable landmark for rotation of the tibial component. Based on the results of this study, surgeons may choose the proper anteroposterior axis of the tibial component in order to reduce rotational mismatch and improve clinical outcomes.
format	article
author	Ji-Hoon Nam Yong-Gon Koh Paul Shinil Kim Gihun Kim Yoon Hae Kwak Kyoung-Tak Kang
author_facet	Ji-Hoon Nam Yong-Gon Koh Paul Shinil Kim Gihun Kim Yoon Hae Kwak Kyoung-Tak Kang
author_sort	Ji-Hoon Nam
title	Evaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging
title_short	Evaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging
title_full	Evaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging
title_fullStr	Evaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging
title_full_unstemmed	Evaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging
title_sort	evaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/37e652de4ec3475fa8a177dac6bcd6a6
work_keys_str_mv	AT jihoonnam evaluationoftibialrotationalaxisintotalkneearthroplastyusingmagneticresonanceimaging AT yonggonkoh evaluationoftibialrotationalaxisintotalkneearthroplastyusingmagneticresonanceimaging AT paulshinilkim evaluationoftibialrotationalaxisintotalkneearthroplastyusingmagneticresonanceimaging AT gihunkim evaluationoftibialrotationalaxisintotalkneearthroplastyusingmagneticresonanceimaging AT yoonhaekwak evaluationoftibialrotationalaxisintotalkneearthroplastyusingmagneticresonanceimaging AT kyoungtakkang evaluationoftibialrotationalaxisintotalkneearthroplastyusingmagneticresonanceimaging
_version_	1718383447623335936

Evaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging

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