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  4. Tibial component positioning in total knee arthroplasty: bone coverage and extensor apparatus alignment
 
research article

Tibial component positioning in total knee arthroplasty: bone coverage and extensor apparatus alignment

Lemaire, P.
•
Pioletti, Dominique P.  
•
Meyer, F. M.
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1997
knee surgery sports traumatology arthroscopy

Correct positioning of the tibial component in total knee arthroplasty (TKA) must take into account both an optimal bone coverage (defined by a maximal cortical bearing with posteromedial and anterolateral support) and satisfactory patellofemoral tracking. Consequently, a compromise position must be found by the surgeon during the operation to simultaneously meet these two requirements. Moreover, tibial tray positioning depends upon the tibial torsion, which has been shown to act mainly in the proximal quarter of the tibia. Therefore, the correct application of the tibial tray is also theoretically related to the level of bone resection. In this study, we first quantified the torsional profile given by an optimal bone coverage for a symmetrical tibial tray design and for an asymmetrical one. Then, for the two types of tibial trays, we measured the angle difference between optimal bone coverage and an alignment on the middle of the tibial tubercule. Results showed that the values of the torsional profile given by the symmetrical tray were more scattered than those from the asymmetrical one. However, determination of the mean differential angle between the position providing optimal bone coverage and the one providing the best patellofemoral tracking indicated that the symmetrical prosthetic tray offered the best compromise between these two requirements. Although the tibiofemoral joint is known to be asymmetric in both shape and dimension, the asymmetrical tray chosen in this study was found to fulfill this compromise with more difficulty.

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Type
research article
DOI
10.1007/s001670050059
PubMed ID

9430576

Author(s)
Lemaire, P.
Pioletti, Dominique P.  
Meyer, F. M.
Meuli, R.
Dorfl, J.
Leyvraz, P. F.  
Date Issued

1997

Published in
knee surgery sports traumatology arthroscopy
Volume

5

Issue

4

Start page

251

End page

7

Subjects

Aged

•

Arthroplasty

•

Replacement

•

Knee/*methods

•

Female

•

Humans

•

Knee Prosthesis

•

Male

•

Middle Aged

•

Prosthesis Design

Note

Hopital Orthopedique de la Suisse Romande, Lausanne, Switzerland. Journal Article

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

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Available on Infoscience
July 25, 2006
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/232657
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