title: Importance of the lateral anatomic tibial slope as a guide to the tibial cut in total knee arthroplasty in Japanese patients.
abstract: Using three-dimensional computed tomography in 50 osteoarthritic knees, we simulated at various cutting angles the tibial cut for total knee arthroplasty. Cutting angles of 0 degrees, 3 degrees, 5 degrees, 7 degrees, 9 degrees, and 11 degrees were used. We then calculated the anterior and posterior thicknesses, the medial-lateral widths, and the medial and lateral condylar depths of the resected tibial bone at each cutting angle. Each set of measurements was evaluated according to a comparison between the cutting angle and the anatomic posterior slopes. The cutting angles showing the smallest anterior-posterior difference at the medial and lateral plateaus were 9 degrees and 7 degrees, respectively. The mean anatomic posterior slopes at the medial and lateral plateaus were 9.0 degrees and 8.1 degrees, respectively. When the tibia was cut at the cutting angle closest to the medial anatomical posterior slope in each knee, the thickness of the lateral posterior plateaus resected from 12 knees (24%) was more than 10 mm. Among these 12 knees, the cutting angle was more than 9 degrees in 9 knees (75%). In contrast, when the tibia was cut at the cutting angle closest to the lateral anatomical posterior slope, only one resected medial posterior plateau was more than 10 mm. The cutting angle of this case was 7 degrees. Therefore, in consideration of the thickness of bone resection from anatomic posterior slope, we demonstrated the importance of using the lateral anatomic posterior tibial slope as a guide to the tibial cut. There was no significant difference with respect to resected bone morphology at any cutting angle.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kuwano
authors.forename: Ken
authors.initials: K
authors.lastname: Urabe
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Miura
authors.forename: Ryuji
authors.initials: R
authors.lastname: Nagamine
authors.forename: Shuichi
authors.initials: S
authors.lastname: Matsuda
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Satomura
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Sasaki
authors.forename: Shuuji
authors.initials: S
authors.lastname: Sakai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Iwamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007720:Knee Prosthesis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy; D015203:Reproducibility of Results; D013977:Tibia / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome