A Coronal Landmark for Tibial Component Positioning With Anatomical Alignment in Total Knee Arthroplasty: A Radiological and Clinical Study

ObjectiveThe purpose of this study was to investigate the value of the lateral point of articular surface of distal tibia (LADT) for anatomical alignment in total knee arthroplasty. MethodsWe reconstructed 148 three-dimensional pre-arthritic tibias and measured the tibial component inclination angle corresponding to the distal landmark of LADT. A retrospective study included 81 TKA recipients divided into the AA group and MA group. Clinical assessments including ROM, HSS, WOMAC, satisfaction for surgery, and radiological assessment were evaluated at one-year follow-up. ResultsThe tibial component varus angle corresponding to the distal landmark of LADT in the male and female groups were 3.4 +/- 0.3 degrees (2.6~4.2 degrees) and 3.2 +/- 0.3 degrees (2.3~4.0 degrees), respectively (P <0.05). Using LADT as the distal landmark for extramedullary tibial cutting guidance, the medial proximal tibia angle (MPTA) of the AA group was 87.0 +/- 1.2 degrees (85.0~90.0 degrees), and the AA and MA technique showed no difference in improvement in postoperative knee functional recovery at final follow-up. ConclusionsThis study preliminarily indicated that LADT can be a reliable and economical landmark for coronal plane alignment of the tibial component.