ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2014
Accuracy of the second metatarsal as a landmark for the extramedullary tibial cutting guide in total knee arthroplasty.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 14 citations in OpenAlex.
- Clinical outcomes of intramedullary tibial guides in total knee arthroplasty: experience from a single-centre cohort.Journal of orthopaedic surgery and research · 2025Article
- [Value of personalized extramedullary positioning technique on tibia side for coronal alignment of tibial prosthesis in total knee arthroplasty].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2022Article
- Efficacy Analysis of Selection of Distal Reference Point for Tibial Coronal Plane Osteotomy during Total Knee Arthroplasty: A Literature Review.Orthopaedic surgery · 2021Review
- Effects of different prosthetic instrumentations on tibial bone resection in total knee arthroplasty.Scientific reports · 2021Article
- The entry point of intramedullary tibia cutting guide should vary according to the individual tibia morphology in TKA.Archives of orthopaedic and trauma surgery · 2020Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to evaluate the accuracy of the second metatarsal (MT2) as a landmark for proximal tibial cutting in total knee arthroplasty (TKA). It was hypothesized that the accuracy of the MT2 is not high, especially in rheumatoid arthritis (RA) patients whose foot joints are apt to be involved.
methodsComputer simulation studies on 48 RA knees and 45 osteoarthritis (OA) knees were performed. The deviations from the mechanical axis (MA) of the tibia when the guide rod was pointed toward the base of the MT2 or the distal part of the MT2 were measured.
resultsThe mean deviation from MA was 0.8° ± 2.1° valgus (range 8.1°-6.3° valgus) and 1.2° ± 2.9° valgus (range 11.6°-7.9° valgus) at the base of the MT2, and at the distal part of the MT2, respectively. The outlier rate when using the base of the MT2 was lower than when using the distal part of the MT2 (12.9 vs 32.3%, p = 0.0032). The outlier rate was equivalent in OA and RA patients (n.s.). However, foot involvement in RA patients demonstrated a trend toward significance (base of MT2 p = 0.078, distal part of MT2 p = 0.068).
conclusionsThe major clinical relevance was to raise caution about using the MT2. Surgeons should aim toward the base of the MT2, but avoid using it in RA patients with foot involvement. The accuracy of the MT2 is not high and it should be used only to supplement other landmarks. LEVEL OF EVIDENCE: II.
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