title: Tibial component alignment after total knee arthroplasty with intramedullary instrumentation: a prospective analysis.
abstract: The best operative technique for achieving appropriate postoperative alignment following total knee arthroplasty (TKA) remains controversial, with proponents of extramedullary, intramedullary and computer-assisted techniques. One hundred ninety-two consecutive patients undergoing TKA were prospectively evaluated with full-length lower extremity radiographs. Patients underwent cemented TKA using femoral and tibial intramedullary instrumentation. Digital radiographs were analyzed using PACS (AGFA Healthcare, Ridgefield Park, NJ) software. Tibial component alignment was measured in the coronal and sagittal planes. Tibial component slope averaged 3.89° + 1.96 for the cruciate-retaining components and averaged 1.7° + 1.92 for PS components. The average coronal tibial component alignment was 90.00°, and 99% were within 3° of neutral mechanical alignment with only 2 (1%) outliers. Intramedullary instrumentation resulted in excellent postoperative tibial component and lower extremity alignment.
authors.affiliation: Department of Orthopaedic Surgery and Orthopaedic Research, New England Baptist Hospital, Boston, Massachusetts 02120, USA.
authors.forename: Carl T
authors.initials: CT
authors.lastname: Talmo
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Cooper
authors.forename: Tom
authors.initials: T
authors.lastname: Wuerz
authors.forename: Jason E
authors.initials: JE
authors.lastname: Lang
authors.forename: James V
authors.initials: JV
authors.lastname: Bono
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods; D017760:Bone Malalignment / Q000000981:diagnostic imaging / Q000517:prevention & control*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D011446:Prospective Studies; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging* / Q000601:surgery