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BONE ANATOMY IN DETERMINING THE ROTATIONAL ALIGNMENT IN TOTAL KNEE ARTHROPLASTY-ANALYSIS WITH COMPUTED TOMOGRAPHY



Abstract

The purpose of this study was to investigate the bone anatomy in determining the rotational alignment in total knee arthroplasty (TKA) using CT scan. Axial CT images of eighty-four varus osteoarthritic knees undergoing TKA were analysed. On the images of the distal femur and the proximal tibia, base line for anterior-posterior axis of each component was drawn based on the epicondylar axis for the femur and medial one-third of the tibial tuberosity for the tibia. Angle between these two lines was analysed as the rotational mismatch between the components when they were determined based on the anatomical landmark of each bone. Thirty-eight knees (45%) showed more than 5-degree mismatch and seven knees (8.3%) showed the mismatch more than 10-degree. There was a tendency to put the tibial component in external rotation relative to the femoral component when they were aligned to medial one-third of the tibial tuberosity. The results have indicated that the landmark of each bone was the intrinsic cause of the rotational mismatch between the components. The surgeons performing TKA surgery should aware of this fact and should align the tibial component in a compromised position, if necessary, to have overall satisfactory clinical outcome.

The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.