Three-dimensional analysis of the tibial resection plane relative to the arthritic tibial plateau in total knee arthroplasty
| Autor: | Mohamed R. Mahfouz, J. Michael Johnson, Stephen M. Howell, Mehmet Rüştü Midillioğlu, Alexander J. Nedopil |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Kinematics Population Tibial resection 03 medical and health sciences 0302 clinical medicine Kinematic Alignment lcsh:Orthopedic surgery medicine Deformity Orthopedics and Sports Medicine Tibia Fibula education Orthodontics Varus deformity 030222 orthopedics education.field_of_study medicine.diagnostic_test business.industry Research Magnetic resonance imaging 030229 sport sciences medicine.disease musculoskeletal system Arthritic tibia Surgery lcsh:RD701-811 Three-dimensional surgical planning Tibial joint line Total knee arthroplasty Tibial plateau Orthopedic surgery medicine.symptom business |
| Zdroj: | Journal of Experimental Orthopaedics, Vol 4, Iss 1, Pp 1-9 (2017) Journal of Experimental Orthopaedics |
| ISSN: | 2197-1153 |
| DOI: | 10.1186/s40634-017-0099-z |
| Popis: | Background Kinematically aligned total knee arthroplasty strives to correct the arthritic deformity by restoring the native tibial joint line. However, the precision of such surgical correction needs to be quantified in order to reduce recuts of the resection and to design assisting instrumentation. This study describes a method for novel three-dimensional analysis of tibial resection parameters in total knee arthroplasty. Pre-operative versus post-operative differences in the slopes of the varus-valgus and flexion-extension planes and the proximal-distal level between the tibia resection and the arthritic tibial joint line can reliably be measured using the three-dimensional models of the tibia and fibula. This work uses the proposed comparison method to determine the parameters for resecting the tibia in kinematically aligned total knee arthroplasty. Methods Three-dimensional shape registration was performed between arthritic surface models segmented from pre-operative magnetic resonance imaging scans and resected surface models segmented from post-operative computed tomography scans. Mean, standard deviation and 95% confidence intervals were determined for all measurements. Results Results indicate that kinematically aligned total knee arthroplasty consistently corrects the varus deformity and restores the slope of the flexion-extension plane and the proximal-distal level of the arthritic tibial joint line. The slope of the varus-valgus plane is most precisely associated with the overall arthritic slope after approximately 3° of correction and the posterior slope is biased towards the overall arthritic plateau, though less precisely than the varus correlation. Conclusions Use of this analysis on a larger population can quantify the effectiveness of the tibial resection for correcting pathologies, potentially reduce imprecisions in the surgical technique, and enable development of instrumentation that reduces the risk of resection recuts. The kinematic alignment technique consistently corrects varus deformities. |
| Databáze: | OpenAIRE |
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