Approximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation

Abstract Traditionally, the practice of the tibial component placement in total knee arthroplasty has focused on achieving maximum coverage without malrotation. However, the concept of maximizing coverage has not been well defined or researched and yet biased results are often produced. This study a...

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Autores principales:	Long Shao, Xiang-Dong Wu, Ting Wang, Xiao-Kang Liu, Wei Xu, Wei Huang, Zhi-Min Zeng
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f0ee58955fd740e9bd28ea5bb388044f
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spelling	oai:doaj.org-article:f0ee58955fd740e9bd28ea5bb388044f2021-12-02T16:31:53ZApproximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation10.1038/s41598-020-67613-22045-2322https://doaj.org/article/f0ee58955fd740e9bd28ea5bb388044f2020-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-67613-2https://doaj.org/toc/2045-2322Abstract Traditionally, the practice of the tibial component placement in total knee arthroplasty has focused on achieving maximum coverage without malrotation. However, the concept of maximizing coverage has not been well defined or researched and yet biased results are often produced. This study aimed to evaluate the effect of a prioritizing maximum coverage positioning strategy on the rotational alignment by using a strict computer algorithm. Computed tomographic scans of 103 tibial specimens were used to reconstruct three-dimensional tibia models. A virtual surgery was performed to generate the resection plane with a posterior slope of 7° on the proximal tibia. Symmetrical and anatomical tibial components were placed and analyzed with an automated program designed for approximating the maximum coverage based on the coherent point drift algorithm. We found that the average tibial coverage achieved across all specimens and implants was 85.62 ± 3.65%, ranging from 83.64 ± 4.10% to 86.69 ± 3.07%. When placed for maximal tibial coverage, the mean degree of rotation related to the Insall line was − 0.73° ± 4.53° for all subjects, 23% of the tibial components were malrotated. The average percentage position of the baseplate anteroposterior axis over the patellar tendon was 26.95 ± 14.71% from the medial edge. These results suggest that with specific design and proper placement of the component, approximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation. The current tibial baseplates have shown good performance on the coverage when aligned parallel to the Insall line with the anteroposterior axis positioned between the medial 1/3 and medial 1/6 of the patella tendon.Long ShaoXiang-Dong WuTing WangXiao-Kang LiuWei XuWei HuangZhi-Min ZengNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-9 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Long Shao Xiang-Dong Wu Ting Wang Xiao-Kang Liu Wei Xu Wei Huang Zhi-Min Zeng Approximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation
description	Abstract Traditionally, the practice of the tibial component placement in total knee arthroplasty has focused on achieving maximum coverage without malrotation. However, the concept of maximizing coverage has not been well defined or researched and yet biased results are often produced. This study aimed to evaluate the effect of a prioritizing maximum coverage positioning strategy on the rotational alignment by using a strict computer algorithm. Computed tomographic scans of 103 tibial specimens were used to reconstruct three-dimensional tibia models. A virtual surgery was performed to generate the resection plane with a posterior slope of 7° on the proximal tibia. Symmetrical and anatomical tibial components were placed and analyzed with an automated program designed for approximating the maximum coverage based on the coherent point drift algorithm. We found that the average tibial coverage achieved across all specimens and implants was 85.62 ± 3.65%, ranging from 83.64 ± 4.10% to 86.69 ± 3.07%. When placed for maximal tibial coverage, the mean degree of rotation related to the Insall line was − 0.73° ± 4.53° for all subjects, 23% of the tibial components were malrotated. The average percentage position of the baseplate anteroposterior axis over the patellar tendon was 26.95 ± 14.71% from the medial edge. These results suggest that with specific design and proper placement of the component, approximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation. The current tibial baseplates have shown good performance on the coverage when aligned parallel to the Insall line with the anteroposterior axis positioned between the medial 1/3 and medial 1/6 of the patella tendon.
format	article
author	Long Shao Xiang-Dong Wu Ting Wang Xiao-Kang Liu Wei Xu Wei Huang Zhi-Min Zeng
author_facet	Long Shao Xiang-Dong Wu Ting Wang Xiao-Kang Liu Wei Xu Wei Huang Zhi-Min Zeng
author_sort	Long Shao
title	Approximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation
title_short	Approximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation
title_full	Approximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation
title_fullStr	Approximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation
title_full_unstemmed	Approximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation
title_sort	approximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/f0ee58955fd740e9bd28ea5bb388044f
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Approximating the maximum tibial coverage in total knee arthroplasty does not necessarily result in implant malrotation

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