Tibial component positioning in total knee arthroplasty: bone coverage and extensor apparatus alignment.

Details

Serval ID
serval:BIB_4C635987595B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Tibial component positioning in total knee arthroplasty: bone coverage and extensor apparatus alignment.
Journal
Knee Surgery, Sports Traumatology, Arthroscopy
Author(s)
Lemaire P., Pioletti D.P., Meyer F.M., Meuli R., Dörfl J., Leyvraz P.F.
ISSN
0942-2056
Publication state
Published
Issued date
1997
Peer-reviewed
Oui
Volume
5
Number
4
Pages
251-257
Language
english
Abstract
Correct positioning of the tibial component in total knee arthroplasty (TKA) must take into account both an optimal bone coverage (defined by a maximal cortical bearing with posteromedial and anterolateral support) and satisfactory patellofemoral tracking. Consequently, a compromise position must be found by the surgeon during the operation to simultaneously meet these two requirements. Moreover, tibial tray positioning depends upon the tibial torsion, which has been shown to act mainly in the proximal quarter of the tibia. Therefore, the correct application of the tibial tray is also theoretically related to the level of bone resection. In this study, we first quantified the torsional profile given by an optimal bone coverage for a symmetrical tibial tray design and for an asymmetrical one. Then, for the two types of tibial trays, we measured the angle difference between optimal bone coverage and an alignment on the middle of the tibial tubercule. Results showed that the values of the torsional profile given by the symmetrical tray were more scattered than those from the asymmetrical one. However, determination of the mean differential angle between the position providing optimal bone coverage and the one providing the best patellofemoral tracking indicated that the symmetrical prosthetic tray offered the best compromise between these two requirements. Although the tibiofemoral joint is known to be asymmetric in both shape and dimension, the asymmetrical tray chosen in this study was found to fulfill this compromise with more difficulty.
Keywords
Aged, Arthroplasty, Replacement, Knee, Female, Humans, Knee Prosthesis, Male, Middle Aged, Prosthesis Design
Pubmed
Create date
08/04/2008 14:47
Last modification date
20/08/2019 14:00
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