Improved angle accuracy of tibial plateau osteotomy for total knee arthroplasty using tibial mechanical axis skin-mapping
BackgroundThe tibial crest is often used as an anatomic landmark for tibial plateau osteotomy (TPO) in total knee arthroplasty (TKA), but it is not very accurate. This study aimed to investigate errors in using the tibial crest as a marker and present a simple approach to improve the angle accuracy...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.961667/full |
| _version_ | 1797959985625300992 |
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| author | Peiheng He Shuai Huang Yong Liu Xing Li Dongliang Xu |
| author_facet | Peiheng He Shuai Huang Yong Liu Xing Li Dongliang Xu |
| author_sort | Peiheng He |
| collection | DOAJ |
| description | BackgroundThe tibial crest is often used as an anatomic landmark for tibial plateau osteotomy (TPO) in total knee arthroplasty (TKA), but it is not very accurate. This study aimed to investigate errors in using the tibial crest as a marker and present a simple approach to improve the angle accuracy of TPO by mapping the tibial mechanical axis (TMA), determined preoperatively, according to the tibial crest on the skin overlying the tibia.MethodsWe evaluated 50 healthy young volunteers and 100 pre-TKA osteoarthritic knees. The middle tibial crest lines (MTCLs) were marked on the shank tibial skin and covered with Kirschner wires. All participants underwent two sets of anteroposterior (AP) standing radiographs of the lower extremity, with the feet in neutral and external rotation positions. The MTCL–TMA angles were measured and compared. The TMA was mapped onto the tibial skin according to the MTCL–TMA angle prior to TKA and used for TPO. Postoperative outcomes were determined by the angle between the vertical tibial component axis (TCA) and the TMA.ResultsThe MTCL had no evident relationship with the TMA. A few MTCLs were parallel to the TMA. External rotation of the foot significantly changed the MTCL–TMA relationship. The angle accuracy of the TPO as guided by TMA skin-mapping was 0.83 ± 0.76°. No postoperative errors exceeded 3°.ConclusionThe MTCL was not equivalent to the TMA. The TPO error can be reduced by preoperatively marking the TMA on the tibial skin according to the MTCL. |
| first_indexed | 2024-04-11T00:40:44Z |
| format | Article |
| id | doaj.art-c94de7f710d841c0bb0d9ec5f52e1302 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T00:40:44Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-c94de7f710d841c0bb0d9ec5f52e13022023-01-06T08:55:50ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-01-01910.3389/fsurg.2022.961667961667Improved angle accuracy of tibial plateau osteotomy for total knee arthroplasty using tibial mechanical axis skin-mappingPeiheng HeShuai HuangYong LiuXing LiDongliang XuBackgroundThe tibial crest is often used as an anatomic landmark for tibial plateau osteotomy (TPO) in total knee arthroplasty (TKA), but it is not very accurate. This study aimed to investigate errors in using the tibial crest as a marker and present a simple approach to improve the angle accuracy of TPO by mapping the tibial mechanical axis (TMA), determined preoperatively, according to the tibial crest on the skin overlying the tibia.MethodsWe evaluated 50 healthy young volunteers and 100 pre-TKA osteoarthritic knees. The middle tibial crest lines (MTCLs) were marked on the shank tibial skin and covered with Kirschner wires. All participants underwent two sets of anteroposterior (AP) standing radiographs of the lower extremity, with the feet in neutral and external rotation positions. The MTCL–TMA angles were measured and compared. The TMA was mapped onto the tibial skin according to the MTCL–TMA angle prior to TKA and used for TPO. Postoperative outcomes were determined by the angle between the vertical tibial component axis (TCA) and the TMA.ResultsThe MTCL had no evident relationship with the TMA. A few MTCLs were parallel to the TMA. External rotation of the foot significantly changed the MTCL–TMA relationship. The angle accuracy of the TPO as guided by TMA skin-mapping was 0.83 ± 0.76°. No postoperative errors exceeded 3°.ConclusionThe MTCL was not equivalent to the TMA. The TPO error can be reduced by preoperatively marking the TMA on the tibial skin according to the MTCL.https://www.frontiersin.org/articles/10.3389/fsurg.2022.961667/fullmiddle tibia crest linetibia mechanical axisskin marktibia plateau osteotomytotal knee arthroplasty |
| spellingShingle | Peiheng He Shuai Huang Yong Liu Xing Li Dongliang Xu Improved angle accuracy of tibial plateau osteotomy for total knee arthroplasty using tibial mechanical axis skin-mapping Frontiers in Surgery middle tibia crest line tibia mechanical axis skin mark tibia plateau osteotomy total knee arthroplasty |
| title | Improved angle accuracy of tibial plateau osteotomy for total knee arthroplasty using tibial mechanical axis skin-mapping |
| title_full | Improved angle accuracy of tibial plateau osteotomy for total knee arthroplasty using tibial mechanical axis skin-mapping |
| title_fullStr | Improved angle accuracy of tibial plateau osteotomy for total knee arthroplasty using tibial mechanical axis skin-mapping |
| title_full_unstemmed | Improved angle accuracy of tibial plateau osteotomy for total knee arthroplasty using tibial mechanical axis skin-mapping |
| title_short | Improved angle accuracy of tibial plateau osteotomy for total knee arthroplasty using tibial mechanical axis skin-mapping |
| title_sort | improved angle accuracy of tibial plateau osteotomy for total knee arthroplasty using tibial mechanical axis skin mapping |
| topic | middle tibia crest line tibia mechanical axis skin mark tibia plateau osteotomy total knee arthroplasty |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.961667/full |
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