ArticleArchives of orthopaedic and trauma surgery2020
Accuracy of tibial positioning in the frontal plane: a prospective study comparing conventional and innovative techniques in total knee arthroplasty.
Article in Archives of orthopaedic and trauma surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparison of clinical outcomes of VISIONAIRE patient-specific instrumentation with conventional instrumentation in total knee arthroplasty: a systematic literature review and meta-analysis.Archives of orthopaedic and trauma surgery · 2023Pooled it
- Accuracy of different navigation systems for femoral and tibial implantation in total knee arthroplasty: a randomised comparative study.Archives of orthopaedic and trauma surgery · 2021Trial
- Clinical outcomes of intramedullary tibial guides in total knee arthroplasty: experience from a single-centre cohort.Journal of orthopaedic surgery and research · 2025Article
- Article
- Customized-individually-made origin® implants in total knee arthroplasty allow a reliable solution for accurate reproduction of planned implant positioning.Journal of experimental orthopaedics · 2023Article
- Increasing grades of frontal deformities in knee osteoarthritis are not associated with ligamentous ankle instabilities.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Fostering Excellence in Knee Arthroplasty: Developing Optimal Patient Care Pathways and Inspiring Knowledge Transfer of Advanced Surgical Techniques.Journal of healthcare leadership · 2023Article
- Handheld computer-navigated constrained total knee arthroplasty for complex extra-articular deformities.Archives of orthopaedic and trauma surgery · 2021Article
- Customised, individually made total knee arthroplasty shows promising 1-year clinical and patient reported outcomes.Archives of orthopaedic and trauma surgery · 2021Review
- [Research progress on comparison of the application effects between personal specific instrumentation and computer-assisted navigation surgery 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 · 2021Article
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCoronal alignment of the tibial component determines functional outcome and survival in total knee arthroplasty (TKA). Innovative techniques for tibial instrumentation have been developed to improve accuracy and reduce the rate of outliers.
methodsIn a prospective study, 300 patients were allocated to four different groups using a randomization process (two innovative and two conventional) techniques of tibial instrumentation (conventional: extramedullary, intramedullary; innovative: navigation and patient-specific instrumentation (PSI); n = 75 for each group). The aims were to reconstruct the medial proximal tibial angle (MPTA) to 90° and the mechanical tibio-femoral axis (mTFA) to 0°. Both angles were evaluated and compared between all groups three months after the surgery. Patients who presented with a postoperative mTFA > 3° were classified as outliers.
resultsThe navigation and intramedullary technique both demonstrated that they were significantly more precise in reconstructing a neutral mTFA and MPTA compared to the other two techniques. The odd's ratio (OR) for producing outliers was highest for the PSI method (PSI OR = 5.5, p < 0.05; extramedullary positioning OR = 3.7, p > 0.05; intramedullary positioning OR = 1.7, p > 0.05; navigation OR = 0.04, p < 0.05). We could only observe significant differences between pre- and postoperative MPTA in the navigation and intramedullary group. The MPTA showed a significant negative correlation with the mTFA in all groups preoperatively and in the extramedullary, intramedullary and PSI postoperatively.
conclusionThe navigation and intramedullary instrumentation provided the precise positioning of the tibial component. Outliers were most common within the PSI and extramedullary technique. Optimal alignment is dependent on the technique of tibial instrumentation and tibial component positioning determines the accuracy in TKA since mTFA correlated with MPTA pre- and postoperatively.
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