Evidence map›Paper›PMID 29556891›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2018

Preoperative tibial mechanical axis orientation and articular surface design influence on the coronal joint line orientation relative to the ground during gait after total knee arthroplasties.

Koji Murakami, Satoshi Hamai, Ken Okazaki, Satoru Ikebe, Hidehiko Higaki, Takeshi Shimoto, Yasuharu Nakashima

Abstract read
PubMed Publisher
In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Koji MurakamiDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 1-3-3 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Satoshi HamaiDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 1-3-3 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. hamachan@ortho.med.kyushu-u.ac.jp.
Ken OkazakiDepartment of Orthopaedic Surgery, Tokyo Women's Medical University, 1-8 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666, Japan.
Satoru IkebeDepartment of Biorobotics, Faculty of Engineering, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka, 813-8583, Japan.
Hidehiko HigakiDepartment of Biorobotics, Faculty of Engineering, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka, 813-8583, Japan.
Takeshi ShimotoDepartment of Information and Systems Engineering, Faculty of Information Engineering, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka, 811-0295, Japan.
Yasuharu NakashimaDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 1-3-3 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNeutral lower limb alignment does not necessarily produce a horizontal joint line after total knee arthroplasty (TKA). The orientation of the pre- and postoperative tibial mechanical axes (TMAs-G), tibial component, and joint line relative to the ground were evaluated.

methodsThe study group included 46 knees, 23 posterior-stabilized (PS) and 23 bicruciate-stabilized (BCS) TKAs. Using whole-leg standing radiographs, the static orientation of the pre- and postoperative TMAs-G and the tibial component as well as the postoperative alignment were measured. Applying image-matching techniques, the dynamic coronal orientation of the tibial component and joint line over the stance phase of gait were analysed. The correlation between static and dynamic orientation of the tibial component and differences in the joint line between the PS and BCS TKAs were evaluated.

resultsIn standing, the postoperative TMA-G (0.8° ± 2.8°) and tibial component (1.5° ± 2.4°) were laterally tilted with a strong correlation. The preoperative lateral tilt of the TMA-G (7.9° ± 5.1°) was a significant predictor of the postoperative TMA-G. The lateral tilt of the tibial component increased to 5.1° ± 2.4° on dynamic analysis, and was moderately correlated to static orientation. The dynamic orientation of the joint line was smaller for the BCS (1.8° ± 2.4°) compared to the PS (5.5° ± 2.7°) TKA.

conclusionEven with a mechanically well-aligned TKA, a lateral tilt of the tibial component was identified due to the lateral tilt of the postoperative TMA-G and the stance phase of gait. The BCS can better accommodate the residual lateral tilt of the joint line due to the 3° medial inclination of the joint surfaces of the implant. This study increases the awareness of surgeons regarding the possibility of the coronal joint line orientation to influence preoperative TMA-G and be accommodated by articular surface design, even in mechanically aligned TKA. LEVEL OF EVIDENCE: IV.

Indexed as

Arthroplasty, Replacement, KneeAgedComputer-Aided DesignFemaleGaitHumansKnee JointKnee ProsthesisMalePostoperative PeriodPreoperative PeriodRadiographyTibiaGaitImage-matching techniquesJoint line orientationTibial mechanical axisTotal knee arthroplasty

Identifiers

PMID29556891

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.