Anteroposterior axis of the tibia for kinematic aligned total knee arthroplasty

Abstract Purpose It is not known where the anatomical axis of rotation on the tibial side will be in kinematic alignment (KA), a rapidly expanding area of total knee arthroplasty (TKA) alignment technique today. The purpose of this study was to define the tibial axis for KA‐TKA. Methods Fifty patien...

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Main Authors: Seikai Toyooka, Noriaki Arai, Hironari Masuda, Hirotaka Kawano, Takumi Nakagawa
Format: Article
Language:English
Published: Wiley 2024-10-01
Series:Journal of Experimental Orthopaedics
Subjects:
Online Access:https://doi.org/10.1002/jeo2.70087
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author Seikai Toyooka
Noriaki Arai
Hironari Masuda
Hirotaka Kawano
Takumi Nakagawa
author_facet Seikai Toyooka
Noriaki Arai
Hironari Masuda
Hirotaka Kawano
Takumi Nakagawa
author_sort Seikai Toyooka
collection DOAJ
description Abstract Purpose It is not known where the anatomical axis of rotation on the tibial side will be in kinematic alignment (KA), a rapidly expanding area of total knee arthroplasty (TKA) alignment technique today. The purpose of this study was to define the tibial axis for KA‐TKA. Methods Fifty patients who underwent computed tomography (CT) examination of the lower extremities at a single institution were included. The posterior condylar axis (PCA) and surgical epicondylar axis (SEA) were identified in the CT axial view and projected onto the tibial slice. The respective perpendicular lines that pass through was attachment of the posterior cruciate ligament (PCL) were identified as the anatomic axis of rotation of the tibia relative to the PCA and SEA, and the position of each axis of rotation. Furthermore, the relationship of these perpendicular lines with the Akagi line was evaluated. Results The axis of tibial rotation to the SEA was similar to that of the Akagi line; the axis of tibial rotation to the PCA was located approximately 2.9° medial to the Akagi line, and when the origin of the tibial axis was set at the PCL attachment site, the intersection point of the tibial axis was approximately 2.5 mm medial to the medial border of the tibial tuberosity. The distribution of tibial axis had a wide range. Conclusion Although there is a large individual variation, the average tibial axis for KA‐TKA is 2.9° more internally rotated than the Akagi line. Level of Evidence Level IV.
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spelling doaj-art-fa09d27b7ff44385ae65a60dd1f1a0f32024-12-31T15:55:34ZengWileyJournal of Experimental Orthopaedics2197-11532024-10-01114n/an/a10.1002/jeo2.70087Anteroposterior axis of the tibia for kinematic aligned total knee arthroplastySeikai Toyooka0Noriaki Arai1Hironari Masuda2Hirotaka Kawano3Takumi Nakagawa4Department of Orthopaedic Surgery Teikyo University School of Medicine Tokyo JapanDepartment of Orthopaedic Surgery Teikyo University School of Medicine Tokyo JapanDepartment of Orthopaedic Surgery Teikyo University School of Medicine Tokyo JapanDepartment of Orthopaedic Surgery Teikyo University School of Medicine Tokyo JapanDepartment of Orthopaedic Surgery Teikyo University School of Medicine Tokyo JapanAbstract Purpose It is not known where the anatomical axis of rotation on the tibial side will be in kinematic alignment (KA), a rapidly expanding area of total knee arthroplasty (TKA) alignment technique today. The purpose of this study was to define the tibial axis for KA‐TKA. Methods Fifty patients who underwent computed tomography (CT) examination of the lower extremities at a single institution were included. The posterior condylar axis (PCA) and surgical epicondylar axis (SEA) were identified in the CT axial view and projected onto the tibial slice. The respective perpendicular lines that pass through was attachment of the posterior cruciate ligament (PCL) were identified as the anatomic axis of rotation of the tibia relative to the PCA and SEA, and the position of each axis of rotation. Furthermore, the relationship of these perpendicular lines with the Akagi line was evaluated. Results The axis of tibial rotation to the SEA was similar to that of the Akagi line; the axis of tibial rotation to the PCA was located approximately 2.9° medial to the Akagi line, and when the origin of the tibial axis was set at the PCL attachment site, the intersection point of the tibial axis was approximately 2.5 mm medial to the medial border of the tibial tuberosity. The distribution of tibial axis had a wide range. Conclusion Although there is a large individual variation, the average tibial axis for KA‐TKA is 2.9° more internally rotated than the Akagi line. Level of Evidence Level IV.https://doi.org/10.1002/jeo2.70087Akagi linekinematic alignmentposterior condylar axistibia rotationtotal knee arthroplasty
spellingShingle Seikai Toyooka
Noriaki Arai
Hironari Masuda
Hirotaka Kawano
Takumi Nakagawa
Anteroposterior axis of the tibia for kinematic aligned total knee arthroplasty
Journal of Experimental Orthopaedics
Akagi line
kinematic alignment
posterior condylar axis
tibia rotation
total knee arthroplasty
title Anteroposterior axis of the tibia for kinematic aligned total knee arthroplasty
title_full Anteroposterior axis of the tibia for kinematic aligned total knee arthroplasty
title_fullStr Anteroposterior axis of the tibia for kinematic aligned total knee arthroplasty
title_full_unstemmed Anteroposterior axis of the tibia for kinematic aligned total knee arthroplasty
title_short Anteroposterior axis of the tibia for kinematic aligned total knee arthroplasty
title_sort anteroposterior axis of the tibia for kinematic aligned total knee arthroplasty
topic Akagi line
kinematic alignment
posterior condylar axis
tibia rotation
total knee arthroplasty
url https://doi.org/10.1002/jeo2.70087
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AT hirotakakawano anteroposterioraxisofthetibiaforkinematicalignedtotalkneearthroplasty
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