caa a22 4500 605457786 CHVBK 20210128100225.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s00167-014-3236-6 doi (NATIONALLICENCE)springer-10.1007/s00167-014-3236-6 Improving tibial component alignment in total knee arthroplasty [Elektronische Daten] [G. Cinotti, P. Sessa, A. D'Arino, F. Ripani, G. Giannicola] Purpose: Tibia torsion may influence the accuracy of extramedullary instrumentations in total knee arthroplasty (TKA). This study assessed whether the effect of tibial torsion may be overcome using a surgical technique in which the extramedullary rod is aligned to reference points at the proximal tibia only. Methods: A consecutive series of 94 knees that underwent TKA were analyzed. In the first 47 knees (group 1), a standard procedure for tibial component alignment was performed while in the second group of 47 knees, a modified surgical technique was used including the alignment of the extramedullary rod to the reference points at the proximal tibia only (group 2). Lower limb, femoral, and tibial component alignment were measured on postoperative long-leg radiographs. Results: Femorotibial mechanical axes angles were similar in the two groups. Femoral component alignment also did not differ between the groups. A neutral alignment of the tibial component was achieved in 17 and 34% of the knees in group 1 and group 2, respectively (p=0.04). A malalignment of the tibial component >3° was found in 34% of knees in group 1 compared with 4% of those in group 2 (p=0.0001). Conclusions: Coronal alignment of the tibial component may improve by setting the extramedullary rod in line with anatomical references in the proximal tibia only. This technique appears to bypass the influence of tibial torsion on the alignment of the extramedullary guide at the distal tibia. The clinical relevance of the study is that using this technique, the rate of malalignment of the tibial component may be reduced compared to a standard technique in which a fixed reference is used at the ankle joint. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2014 Total knee arthroplasty nationallicence Tibial cut nationallicence Tibial component alignment nationallicence Total knee alignment nationallicence Extramedullary instrumentations nationallicence Cinotti G. Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, University "La Sapienza”, Rome, Italy aut Sessa P. Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, University "La Sapienza”, Rome, Italy aut D'Arino A. Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, University "La Sapienza”, Rome, Italy aut Ripani F. Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, University "La Sapienza”, Rome, Italy aut Giannicola G. Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, University "La Sapienza”, Rome, Italy aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/12(2015-12-01), 3563-3570 0942-2056 23:12<3563 2015 23 167 https://doi.org/10.1007/s00167-014-3236-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3236-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Cinotti G. Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, University "La Sapienza”, Rome, Italy aut NATIONALLICENCE 700 1- Sessa P. Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, University "La Sapienza”, Rome, Italy aut NATIONALLICENCE 700 1- D'Arino A. Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, University "La Sapienza”, Rome, Italy aut NATIONALLICENCE 700 1- Ripani F. Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, University "La Sapienza”, Rome, Italy aut NATIONALLICENCE 700 1- Giannicola G. Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, University "La Sapienza”, Rome, Italy aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/12(2015-12-01), 3563-3570 0942-2056 23:12<3563 2015 23 167