The Posterolateral Corner-Locked Technique Is Applicable in a Chinese Population Regarding the Tibial Component Rotation Alignment in Total Knee Arthroplasty

Chao-Hua Fang; Cheng-Kung Cheng; Tie-Bing Qu; Jun-Hui Zhang; Bo Zhang; Qun Hua; Shi-Gui Yan

doi:10.1055/s-0039-1678536

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2020; 33(05): 466-473
DOI: 10.1055/s-0039-1678536

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Posterolateral Corner-Locked Technique Is Applicable in a Chinese Population Regarding the Tibial Component Rotation Alignment in Total Knee Arthroplasty

Chao-Hua Fang ^*

¹Department of Orthopaedic Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

²Department of Joint Surgery, 6th Hospital of Ningbo, Ningbo, Zhejiang, China

,

Cheng-Kung Cheng^*

³Department of Biomedical Engineering, National Yang Ming University, Taipei, Taiwan

⁴Orthopaedic Device Research Center, National Yang Ming University, Taipei, Taiwan

⁵Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beijing University of Aeronautics and Astronautics, Beijing, China

,

Tie-Bing Qu

⁶Department of Orthopaedics, Capital Medical University School of Rehabilitation Medicine, Beijing Charity Hospital, Beijing, China

,

Jun-Hui Zhang

²Department of Joint Surgery, 6th Hospital of Ningbo, Ningbo, Zhejiang, China

,

Bo Zhang

⁷Department of Orthopaedics, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

,

Qun Hua

²Department of Joint Surgery, 6th Hospital of Ningbo, Ningbo, Zhejiang, China

,

Shi-Gui Yan

¹Department of Orthopaedic Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

› Author Affiliations

Abstract

Rotational malalignment between the femoral and tibial components in total knee arthroplasty (TKA) can affect clinical outcomes, but there is no consensus on how to best determine tibia tray orientation. The posterolateral corner-locked (PLCL) technique may be a new method. This study aims to assess the applicability of this technique in a Chinese population. Forty normal Chinese volunteers were recruited and underwent computed tomography (CT) of the lower limbs. Knee model reconstructions and simulated standard tibial osteotomy were conducted digitally. The transepicondylar axis (TEA), the Akagi line, and the line connecting the medial third of the tibial tubercle with the midpoint of the posterior cruciate ligament (PCL) were projected to the tibial cross-section and marked. The PLCL technique was applied using either symmetrical or asymmetrical tibial tray templates, and the anteroposterior (AP) axis of the tibial tray was marked. The angles between the TEA and these lines were calculated, and the statistical differences were analyzed. The angle between the TEA and the Akagi line and between the TEA and the line connecting the medial third of the tibial tubercle with the midpoint of the PCL were 96.90 ± 5.57 and 107.31 ± 5.95 degrees, respectively. The angles between the TEA and the AP axis of the symmetrical and the asymmetrical design tibial trays were 94.01 ± 4.21 and 96.65 ± 4.70 degrees, respectively. Except for the Akagi line and AP axis of the asymmetrical tibial tray, statistical differences were found between all lines (p < 0.05). The PLCL technique is principally suitable for Chinese patients requiring TKA when using the tibial component referred to in this study, although it may result in slight external rotation.

Keywords

total knee arthroplasty - knee joint - tibia - biomechanical phenomena

Full Text

References

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