Gravity reduces the tibia when using a tibial guide that targets the intercondylar roof.
BACKGROUND
Reduction of the tibia relative to the femur with the knee in maximum extension is required to correctly position the tibial tunnel in the sagittal plane when using a guide that targets the intercondylar roof. The authors found no studies that determined (1) whether gravity reduces the tibia and (2) whether roof impingement is prevented without a roofplasty and without positioning the tibial tunnel too posteriorly.


METHODS
The position of the tibia relative to the femur was measured from a lateral radiograph of the treated knee in maximum extension with and without the tibial guide and of the contralateral normal knee in extension in single-leg stance (control).


RESULTS
The position of the tibia with and without the tibial guide was not different (P = .33, not significant) and was only 0.7 mm more posterior than the control knee (P = .0075). A roofplasty was not required, and the clearance was 2 mm or less.


CONCLUSIONS
Gravity reduces the tibia on the femur when using a guide that targets the intercondylar roof. The use of a tibial guide that targets the intercondylar roof prevents roof impingement without a roofplasty and without positioning the tibial tunnel too posteriorly.
Howell
Stephen M
SM
University of California, Davis, USA. sebhowell@mac.com <sebhowell@mac.com>
Lawhorn
Keith W
KW
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery*; D001858:Bone Nails; D005260:Female; D005269:Femur / Q000033:anatomy & histology; D006112:Gravitation; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation*; D011187:Posture; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000295:instrumentation; D013977:Tibia / Q000033:anatomy & histology* / Q000502:physiology