title: Reliable and reproducible technique to mark center of ankle in total knee arthroplasty.
abstract: OBJECTIVE
  Bony and soft tissue landmarks have been used in the past to determine the center of the ankle to facilitate the tibial cut using an extramedullary guide in total knee arthroplasty. However literature reports are scanty in regards to the most ideal method available and its reproducibility in marking the center of the ankle intra-operatively.
  
  
  METHODS
  We describe a method of using an electrocardiogram (ECG) lead in determining the center of the ankle, thus facilitating the alignment of the extramedullary guide for the tibia.
  
  
  RESULTS
  Using this technique, in our study the mean lateral tibial component angle was 90.09(84.2°-94.3°). The number of knees in the range of 88°-92.4° were 120 out of 122 knees (98.40%).
  
  
  CONCLUSIONS
  The described method is reliable and cheap, with reproducibility in determining the tibial cut in total knee arthroplasty.
authors.affiliation: Associate Consultant in Orthopaedics, Department of Orthopaedics, P.D Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, 400016, India.
authors.forename: Anshul
authors.initials: A
authors.lastname: Sobti
authors.affiliation: Consultant in Orthopaedics, Maniar Clinic, 5/D-3 Khira Nagar, S.V. Road, Santa Cruz West, Mumbai, 400054, India.
authors.forename: Shriji
authors.initials: S
authors.lastname: Maniar
authors.affiliation: Fellow in Trauma & Arthroplasty, P.D Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, 400016, India.
authors.forename: Sameer
authors.initials: S
authors.lastname: Chaudhari
authors.affiliation: Consultant in Orthopaedics Trauma & Arthroplasty, P.D Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg Mahim, Mumbai, 400016, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Shetty
keywords: Centre of ankle; ECG lead; Extramedullary guide; TKA