ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020
Internal rotation of the tibial component in total knee arthroplasty can lead to extension deficit.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Comparison of the coverage and rotation of asymmetrical and symmetrical tibial components: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2024Pooled it
- Causes of stiffness after total knee arthroplasty: a systematic review.International orthopaedics · 2021Pooled it
- Curve-on-curve technique does not improve tibial coverage in total knee arthroplasty in comparison to tibial tuberosity technique with use of anatomical implants: randomized controlled trial.Archives of orthopaedic and trauma surgery · 2023Trial
- Association between abnormal native tibial torsion and poorer clinical outcomes following robotic-assisted total knee arthroplasty: follow-up of at least two years.Journal of robotic surgery · 2026Article
- The augmented reality-aided navigation system may improve rotational alignment of the tibial baseplate in total knee arthroplasty.BMC musculoskeletal disorders · 2025Article
- Curve-on-curve technique is more reliable than free-floating technique for tibial components positioning in posterior stabilized total knee arthroplasty using symmetrical tibial components in varus osteoarthritis.BMC musculoskeletal disorders · 2024Article
- Anteroposterior axis of the tibia for kinematic aligned total knee arthroplasty.Journal of experimental orthopaedics · 2024Article
- Coronal Knee Alignment and Tibial Rotation in Total Knee Arthroplasty: A Prospective Cohort Study of Patients with End-Stage Osteoarthritis.Bioengineering (Basel, Switzerland) · 2024Article
- Prediction of knee biomechanics with different tibial component malrotations after total knee arthroplasty: conventional machine learning vs. deep learning.Frontiers in bioengineering and biotechnology · 2023Article
- Different tibial rotational axes can be applied in combination according to the tibial tuberosity-posterior cruciate ligament distance in total knee arthroplasty.BMC musculoskeletal disorders · 2022Article
- Gender differences affect the location of the patellar tendon attachment site for tibial rotational alignment in total knee arthroplasty.Journal of orthopaedic surgery and research · 2022Article
- Moderate External Rotation of Tibial Component Generates More Natural Kinematics Than Internal Rotation After Total Knee Arthroplasty.Frontiers in bioengineering and biotechnology · 2022Article
- The personalized Berger method is usable to solve the problem of tibial rotation.Journal of experimental orthopaedics · 2021Article
- Finite element analysis of the tibial component alignment in a transverse plane in total knee arthroplasty.Journal of applied biomedicine · 2021Article
- Does the anatomic design of total knee prosthesis allow for a better component fit than its nonanatomic predecessor? A matched cohort Study.Arthroplasty today · 2021Article
- Influence of surgical factors on patient satisfaction after bi-cruciate stabilized total knee arthroplasty: retrospective examination using multiple regression analysis.BMC musculoskeletal disorders · 2021Article
- The use of an asymmetrical tibial tray in TKA optimises tibial rotation when fitted to the posterior tibial plateau border.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeStiffness is a common problem following total knee arthroplasty (TKA). Mal-rotated components have been claimed to be the major cause of pain and limited motion after TKA. The present study investigates whether intra-operative intentional malrotation of the tibial component would change in vivo kinematics. The hypothesis is excessive internal rotation of the tibial component would result in postoperative extension deficit.
methodsThirty-one patients were enrolled in this study. After completing bony cuts and proper soft tissue balancing, the femoral and tibial trials were impacted and fixed using small pins. Lateral radiographs were used to measure and compare intraoperative full knee extension during normal and after intentional internal rotation of the tibial component. The extension deficit angles were also compared between the posterior stabilised (PS) and cruciate retaining (CR) implants.
resultsFor normal tibial component rotation, the median (interquartile range) extension deficit was 0° (4). The mean tibial trial intentional internal rotation was 21.2° (± 4.5). The median (interquartile range) extension deficit significantly increased to 6° (4) after tibial component internal rotation (p = 0.001). The use of PS spacers resulted in a significantly greater extension deficit after intentional internal rotation 9° (5) compared to that of the CR implant 1° (4) (p = 0.001).
conclusionInternal rotation of the tibial component in total knee arthroplasty can lead to postoperative extension deficit. This could be attributed to interference with "screw home" mechanism that requires full external rotation of the tibia on the femur. Consequently, this deficit may cause pain and knee stiffness following TKA. LEVEL OF EVIDENCE: III.
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