title: Evaluation of tibial rotational alignment in total knee arthroplasty: a cadaver study.
abstract: Various techniques exist for establishing tibial rotational alignment during total knee arthroplasty (TKA). The purpose of this study is to establish the most precise and reproducible method to assess tibial component rotational alignment during TKA by comparing the flexion-extension technique (ROM) and the Posterior-lateral Corner Locked Technique (PLCL). Twenty posterior stabilized TKAs were performed on cadavers. The rotation angles of the tibial components obtained using the two techniques were evaluated. The tibial component rotation axis obtained using the ROM technique and the PLCL method averaged, respectively, 0.35 degrees (+ or - 4.2 degrees ) externally rotated and 0.34 degrees (+ or - 3 degrees ) internally rotated to the Akagi line. No significant differences between the two methods were found and a high correlation exists between the two techniques (Pearson's coefficient = 0.88). The ROM and PLCL techniques are both precise and reproducible methods to assess tibial component rotation during TKA. However, while the ROM technique is dependent on the correct positioning of the femoral component and the soft tissue balancing, the PCLC method is easier if a complete visualization of the posterior-lateral corner of the cut tibial plateau is achieved.
authors.affiliation: Department of Orthopaedics and Traumatology, Mauriziano "Umberto I" Hospital, University of Turin Medical School, Largo Turati 62, 10128 Turin, Italy. rossir@fastwebnet.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Rossi
authors.forename: Matteo
authors.initials: M
authors.lastname: Bruzzone
authors.forename: Davide Edoardo
authors.initials: DE
authors.lastname: Bonasia
authors.forename: Antonio
authors.initials: A
authors.lastname: Marmotti
authors.forename: Filippo
authors.initials: F
authors.lastname: Castoldi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000502:physiology*; D008297:Male; D016059:Range of Motion, Articular; D013977:Tibia / Q000502:physiology*