title: Tibial rotational alignment was significantly improved by use of a CT-navigated control device in total knee arthroplasty.
abstract: This study compared the accuracy of three methods to set tibial component rotational alignment: (1) conventional method, the anteroposterior (AP) axis was determined by the surgeon using anatomical landmarks; (2) partial-navigation method, the tibia was prepared according to the AP axis using a CT-based navigation system and the component was manually positioned; (3) full-navigation method, the tibial component was positioned and fixed with cement under the control of navigation using a newly developed instrument. The conventional method showed considerable deviation (range, -18.6° to 14.7°), and the partial-navigation method also showed considerable deviation (-11.3° to 8.1°). In contrast, the full-navigation method significantly improved the accuracy of alignment (-2.9° to 2.1°). The tibial component can become malaligned during cement fixation, even after proper bone preparation.
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors: Shinichi
authors: S
authors: Kuriyama
authors: Department of Orthopaedic Surgery, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan.
authors: Katsufumi
authors: K
authors: Hyakuna
authors: Department of Orthopaedic Surgery, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan.
authors: Satoshi
authors: S
authors: Inoue
authors: Department of Orthopaedic Surgery, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan.
authors: Yasuyuki
authors: Y
authors: Tamaki
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors: Hiromu
authors: H
authors: Ito
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors: Shuichi
authors: S
authors: Matsuda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks; D001168:Arthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods; D017760:Bone Malalignment / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012399:Rotation; D025321:Surgery, Computer-Assisted; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: CT-based navigation system; developed instrument; rotational alignment; tibial component; total knee arthroplasty