Evidence map›Paper›PMID 41278076›Full record

ArticleCureus2025

3D Imaging Evaluation of Distal Reference Axes for Tibial Rotational Alignment in Medial-Type Knee Osteoarthritis.

Taro Uehara, Takaaki Shishido, Ishida Tsunehito, Toshinori Masaoka, Tateiwa Toshiyuki, Kyohei Nagayama, Yasuhito Takahashi, Kengo Yamamoto

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In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Taro UeharaOrthopaedic Surgery, Tokyo Medical University, Tokyo, JPN.
Takaaki ShishidoOrthopaedic Surgery, Tokyo Medical University Hospital, Tokyo, JPN.
Ishida TsunehitoOrthopaedic Surgery, Tokyo Medical University, Tokyo, JPN.
Toshinori MasaokaOrthopaedic Surgery, Tokyo Medical University Hospital, Tokyo, JPN.
Tateiwa ToshiyukiOrthopaedic Surgery, Tokyo Medical University, Tokyo, JPN.
Kyohei NagayamaOrthopaedic Surgery, Tokyo Medical University Hospital, Tokyo, JPN.
Yasuhito TakahashiOrthopaedic Surgery, Tokyo Medical University, Tokyo, JPN.
Kengo YamamotoOrthopaedic Surgery, Tokyo Medical University, Tokyo, JPN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Precise tibial rotational alignment is essential for successful total knee arthroplasty (TKA). While Akagi's line is established proximally, the optimal distal reference axis remains uncertain. Methods We analyzed 120 medial knee osteoarthritis (OA) patients (mean age 71.7 years) using three-dimensional computed tomography. The proximal anteroposterior (AP) axis (Akagi's line) was compared with three distal axes: ankle AP (d-AP1), talar AP (d-AP2), and second metatarsal bone axis (d-AP3). Associations with Kellgren-Lawrence grade and femorotibial angle were assessed. Results Mean deviations from the proximal axis were -17.55 ± 9.49° (d-AP1), -3.36 ± 10.13° (d-AP2), and -0.85 ± 11.18° (d-AP3). d-AP3 showed the closest alignment and was unaffected by OA severity, though with gender-related variation. d-AP1 rotated externally with increasing varus deformity. Conclusion The second metatarsal axis (d-AP3) provides the most reliable distal reference for tibial rotational alignment in TKA, particularly when proximal landmarks are inaccessible during minimally invasive surgery.

Indexed as

akagi's linedistal reference axisfemoro-tibial anglekellgren-lawrence gradeknee osteo-arthritisrotational alignmenttka (total knee arthoplasty)

Identifiers

PMID41278076
PMCPMC12640230

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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.