ArticleJournal of experimental orthopaedics2024
Intraoperative reliability of the tibial anteroposterior axis "Akagi's Line" in total knee arthroplasty.
Article in Journal of experimental orthopaedics, 2024. 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.
- Three-dimensional verification of osteotomy accuracy in total knee arthroplasty using intraoperative CT imaging: a case series study.BMC musculoskeletal disorders · 2025Article
- The augmented reality-aided navigation system may improve rotational alignment of the tibial baseplate in total knee arthroplasty.BMC musculoskeletal disorders · 2025Article
- Anatomical and component rotational mismatches negatively affect postoperative outcomes in total knee arthroplasty.Journal of experimental orthopaedics · 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
- Intraoperative reliability of the tibial anteroposterior axis "Akagi's Line" in total knee arthroplasty.Journal of experimental orthopaedics · 2024Article
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Authors and funding
9 authors.
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Abstract
Purpose: The tibial anatomical anteroposterior (AP) axis "Akagi's line" was originally defined on computed tomography (CT) in total knee arthroplasty (TKA); however, its intraoperative reproducibility remains unknown. This study aimed to evaluate the intraoperative reproducibility of the Akagi's line and its effect on postoperative clinical outcomes. Methods: This prospective study included 171 TKAs. The rotational angle of the intraoperative Akagi's line relative to the original Akagi's line (RAA) defined on CT was measured. The RAA was calculated based on the tibial component rotational angles relative to the intraoperative Akagi's line measured using the navigation system and CT. The effects of RAA on postoperative clinical outcomes and rotational alignments of components were also evaluated. Results: The mean absolute RAA (standard deviation) value was 5.5° (3.9°). The range of RAA was 22° internal rotation to 16° external rotation. Intraoperative Akagi's line outliers (RAA > 10°) were observed in 14% of the knees (24 knees). In outlier analysis, the tibial component rotation angle was externally rotated 6.5° (5.6°) in the outlier group and externally rotated 3.7° (4.2°) in the nonoutlier group (≤10°), with a significant difference between the two groups. Additionally, the outlier group (RAA > 10°) showed lower postoperative clinical outcomes. Conclusion: The original Akagi's line defined on CT showed insufficient reproducibility intraoperatively. The poor intraoperative detection of Akagi's line could be the reason for the tibial component rotational error and worse postoperative clinical outcomes. Level of Evidence: Level IV, case series.
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