The Accuracy of the Lateral Tibial Spine as a Landmark for Lateral Meniscal Allograft Transplantation.
OBJECTIVE
To determine a relationship between the direction of the guide pin for the keyhole in the lateral meniscus (LM) transplantation and the line connecting the centers of both horns of the LM.


METHODS
Forty-four resected tibial plateaus during total knee arthroplasty were used for anatomical and radiological evaluations. The inclusion criterion was medial compartment osteoarthritis. Exclusion criteria were osteoarthritic changes, meniscal tear, and previous fracture in the lateral compartment. Resected tibial plateaus were positioned so that the anterior and posterior parts of the lateral tibial spine (LTS) were overlapped accurately on fluoroscopic anteroposterior view. A wire (Pin-F) was drilled along the peak of the LTS. The insertion area of anterior and posterior horns of the LM was dissected carefully. The periphery and the center of the insertion area of both horns were marked. Another wire (Pin-A) was drilled along a line connecting the centers of both horns. An axial radiograph was taken for each prepared tibial plateau. A longitudinal line was drawn along each wire, and the angle between the 2 wires was measured using the imaging software. If the Pin-F was externally rotated relative to the Pin-A, the angle was designated as positive, and if the Pin-F was internally rotated, the angle was designated as negative.


RESULTS
The mean angle between Pin-F and Pin-A was -7.4° ± 9.6°. Thirty-three (75%) Pin-Fs were fixed in an internally rotated position, and 11 (25%) were fixed in an externally rotated position.


CONCLUSIONS
The direction of most guide pins drilled along the LTS was not coincident with the line connecting the centers of both horns of the LM.


CONCLUSIONS
The axis of the LTS is not a reliable marker for the trough in the LM allograft transplantation.
Department of Orthopaedic Surgery, Eulji Medical Center, Seoul, Republic of Korea. Electronic address: cnh2406@yahoo.com.
Nam-Hong
NH
Choi
Department of Orthopaedic Surgery, Eulji Medical Center, Seoul, Republic of Korea.
Byeong-Yeon
BY
Kim
Department of Orthopaedic Surgery, Eulji Medical Center, Seoul, Republic of Korea.
Seuk-Min
SM
Lim
Department of Orthopaedic Surgery, Eulji Medical Center, Seoul, Republic of Korea.
Jae-Hyun
JH
Park
Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, Ohio, U.S.A.
Brian N
BN
Victoroff
D064591:Allografts; D059925:Anatomic Landmarks / Q000000981:diagnostic imaging*; D019645:Arthroplasty, Replacement, Knee; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008592:Menisci, Tibial / Q000637:transplantation*; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery*; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted; D013977:Tibia / Q000000981:diagnostic imaging* / Q000601:surgery