Progress in the method of tibial prosthesis rotation alignment in total knee arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Xin , GUO Shengjie , LI Shuaijie , CAO Yanwei ,  XIANG Chuan

Department of Orthopedics, the Second Affiliated Hospital of Shanxi Medical University, Taiyuan Shanxi, 030001, P.R.China;

Corresponding author：

XIANG Chuan, Email: chuanxiang@sxmu.edu.cn

Keywords：

Total knee arthroplasty; tibial prosthesis; rotation alignment

DOI：

10.7507/1002-1892.201911058

Video：

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Objective To summarize the methods of tibial prosthesis rotation alignment in total knee arthroplasty, and provide reference for clinicians to select and further study the methods of tibial prosthesis rotation alignment.Methods The advantages and disadvantages of various tibial prosthesis rotation alignment methods were analyzed and summarized by referring to the relevant literature at home and abroad in recent years.Results There are many methods for tibial prosthesis rotation alignment, including reference to relevant anatomical landmarks, range of motion (ROM) technique, computer-assisted navigation, and personalized osteotomy. The inner one-third of the tibial tuberosity is a more accurate reference anatomical landmark, but the obesity, severe knee deformity and dysplasia have impacts on the precise placement of the tibial prosthesis. ROM technique do not need to refer to the anatomical landmark of the tibia, and aren’t affected by landmark variation. It can be used for severe knee valgus deformity and the landmarks that are difficult to identify. However, it may cause internal rotation of tibial prosthesis. Computer- assisted navigation and personalized osteotomy can achieve more accurate alignment in sagittal, coronal, and rotational alignment of femoral prosthesis. However, due to the lack of reliable anatomical landmarkers related to tibia fixation, it is still controversial whether it can help the alignment of tibial prosthesis rotation.Conclusion The surgeon should master the methods of rotation and alignment of tibial prosthesis, make preoperative plans, select appropriate alignment methods for different patients, and achieve individualization. Meanwhile, several anatomical landmarkers should be referred to properly during the operation, which can be used to detect the correct placement of tibial prosthesis and avoid large rotation error.

Citation： LIU Xin, GUO Shengjie, LI Shuaijie, CAO Yanwei, XIANG Chuan. Progress in the method of tibial prosthesis rotation alignment in total knee arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(9): 1200-1204. doi: 10.7507/1002-1892.201911058 Copy

1.	Bédard M, Vince KG, Redfern J, et al. Internal rotation of the tibial component is frequent in stiff total knee arthroplasty. Clin Orthop Relat Res, 2011, 469(8): 2346-2355.
2.	Kim YH, Park JW, Kim JS, et al. The relationship between the survival of total knee arthroplasty and postoperative coronal, sagittal and rotational alignment of knee prosthesis. Int Orthop, 2014, 38(2): 379-385.
3.	Kuriyama S, Ishikawa M, Furu M, et al. Malrotated tibial component increases medial collateral ligament tension in total knee arthroplasty. J Orthop Res, 2014, 32(12): 1658-1666.
4.	Osano K, Nagamine R, Todo M, et al. The effect of malrotation of tibial component of total knee arthroplasty on tibial insert during high flexion using a finite element analysis. Scientific World Journal, 2014, 2014: 695028.
5.	Schiavone Panni A, Cerciello S, Vasso M, et al. Stiffness in total knee arthroplasty. J Orthop Traumatol, 2009, 10(3): 111-118.
6.	Drexler M, Backstein D, Studler U, et al. The medial border of the tibial tuberosity as an auxiliary tool for tibial component rotational alignment during total knee arthroplasty (TKA). Knee Surg Sports Traumatol Arthrosc, 2017, 25(6): 1736-1742.
7.	Berger RA, Crossett LS, Jacobs JJ, et al. Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res, 1998, (356): 144-153.
8.	Nicoll D, Rowley DI. Internal rotational error of the tibial component is a major cause of pain after total knee replacement. J Bone Joint Surg (Br), 2010, 92(9): 1238-1244.
9.	Eckhoff DG, Metzger RG, Vandewalle MV. Malrotation associated with implant alignment technique in total knee arthroplasty. Clin Orthop Relat Res, 1995, (321): 28-31.
10.	Feczko PZ, Pijls BG, Steijn MJ, et al. Tibial component rotation in total knee arthroplasty. BMC Musculoskelet Disord, 2016, 17: 87.
11.	Gromov K, Korchi M, Thomsen MG, et al. What is the optimal alignment of the tibial and femoral components in knee arthroplasty? Acta Orthop, 2014, 85(5): 480-487.
12.	Insall JN, Binazzi R, Soudry M, et al. Total knee arthroplasty. Clin Orthop Relat Res, 1985, (192): 13-22.
13.	Lawrie CM, Noble PC, Ismaily SK, et al. The flexion-extension axis of the knee and its relationship to the rotational orientation of the tibial plateau. J Arthroplasty, 2011, 26(6 Suppl): 53-58.
14.	Yin L, Chen K, Guo L, et al. Knee alignment in the transverse plane during weight-bearing activity and its implication for the tibial rotational alignment in total knee arthroplasty. Clin Biomech (Bristol, Avon), 2015, 30(6): 565-571.
15.	Akagi M, Oh M, Nonaka T, et al. An anteroposterior axis of the tibia for total knee arthroplasty. Clin Orthop Relat Res, 2004, (420): 213-219.
16.	Howell SM, Chen J, Hull ML. Variability of the location of the tibial tubercle affects the rotational alignment of the tibial component in kinematically aligned total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2013, 21(10): 2288-2295.
17.	Tao K, Cai M, Zhu Y, et al. Aligning the tibial component with medial border of the tibial tubercle—is it always right? Knee, 2014, 21(1): 295-298.
18.	Incavo SJ, Coughlin KM, Pappas C, et al. Anatomic rotational relationships of the proximal tibia, distal femur, and patella: implications for rotational alignment in total knee arthroplasty. J Arthroplasty, 2003, 18(5): 643-648.
19.	Graw BP, Harris AH, Tripuraneni KR, et al. Rotational references for total knee arthroplasty tibial components change with level of resection. Clin Orthop Relat Res, 2010, 468(10): 2734-2738.
20.	Heyse TJ, Stiehl JB, Tibesku CO. Measuring tibial component rotation of TKA in MRI: What is reproducible? Knee, 2015, 22(6): 604-608.
21.	Rossi R, Bruzzone M, Bonasia DE, et al. Evaluation of tibial rotational alignment in total knee arthroplasty: a cadaver study. Knee Surg Sports Traumatol Arthrosc, 2010, 18(7): 889-893.
22.	Uehara K, Kadoya Y, Kobayashi A, et al. Bone anatomy and rotational alignment in total knee arthroplasty. Clin Orthop Relat Res, 2002, (402): 196-201.
23.	余华晨, 温宏, 张宇, 等. Akagi 线作为全膝关节置换胫骨近端假体旋转对线的可靠性研究. 中国骨伤, 2015, 28(10): 884-887.
24.	Berhouet J, Beaufils P, Boisrenoult P, et al. Rotational positioning of the tibial tray in total knee arthroplasty: a CT evaluation. Orthop Traumatol Surg Res, 2011, 97(7): 699-704.
25.	Forster-Horvath C, Kremo V, Müller-Gerbl M, et al. Using the anatomical tibial axis for total knee arthroplasty alignment may lead to an internal rotation error. Int Orthop, 2015, 39(12): 2347-2353.
26.	Martin S, Saurez A, Ismaily S, et al. Maximizing tibial coverage is detrimental to proper rotational alignment. Clin Orthop Relat Res, 2014, 472(1): 121-125.
27.	Hirakawa M, Miyazaki M, Ikeda S, et al. Evaluation of the rotational alignment of the tibial component in total knee arthroplasty: position prioritizing maximum coverage. Eur J Orthop Surg Traumatol, 2017, 27(1): 119-124.
28.	Stulberg SD, Goyal N. Which tibial tray design achieves maximum coverage and ideal rotation: Anatomic, symmetric, or asymmetric? An MRI-based study. J Arthroplasty, 2015, 30(10): 1839-1841.
29.	Baldini A, Indelli PF, DE Luca L, et al. Rotational alignment of the tibial component in total knee arthroplasty: the anterior tibial cortex is a reliable landmark. Joints, 2014, 1(4): 155-160.
30.	Benjamin J. Component alignment in total knee arthroplasty. Instr Course Lect, 2006, 55: 405-412.
31.	Hernandez-Vaquero D, Noriega-Fernandez A, Fernandez-Carreira JM, et al. Computer-assisted surgery improves rotational positioning of the femoral component but not the tibial component in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2014, 22(12): 3127-3134.
32.	Miller MC, Zhang AX, Petrella AJ, et al. The effect of component placement on knee kinetics after arthroplasty with an unconstrained prosthesis. J Orthop Res, 2001, 19(4): 614-620.
33.	Ikeuchi M, Yamanaka N, Okanoue Y, et al. Determining the rotational alignment of the tibial component at total knee replacement: a comparison of two techniques. J Bone Joint Surg (Br), 2007, 89(1): 45-49.
34.	Tsai TY, Dimitriou D, Liow MH, et al. Three-dimensional imaging analysis of unicompartmental knee arthroplasty evaluated in standing position: Component alignment and in vivo articular contact. J Arthroplasty, 2016, 31(5): 1096-1101.
35.	Hetaimish BM, Khan MM, Simunovic N, et al. Meta-analysis of navigation vs conventional total knee arthroplasty. J Arthroplasty, 2012, 27(6): 1177-1182.
36.	Matziolis G, Krocker D, Weiss U, et al. A prospective, randomized study of computer-assisted and conventional total knee arthroplasty. Three-dimensional evaluation of implant alignment and rotation. J Bone Joint Surg (Am), 2007, 89(2): 236-243.
37.	Kim SH, Lee HJ, Jung HJ, et al. Less femoral lift-off and better femoral alignment in TKA using computer-assisted surgery. Knee Surg Sports Traumatol Arthrosc, 2013, 21(10): 2255-2262.
38.	Lombardi AV Jr, Berend KR, Adams JB. Patient-specific approach in total knee arthroplasty. Orthopedics, 2008, 31(9): 927-930.
39.	刘德健, 李彦林, 蔡国锋, 等. 3D 打印截骨导板辅助人工全膝关节置换术早期疗效分析. 中国修复重建外科杂志, 2018, 32(7): 899-905.
40.	孙茂淋, 杨柳, 何锐, 等. 3D 打印导板辅助人工全膝关节置换术后患者步态分析. 中国修复重建外科杂志, 2019, 33(8): 953-959.
41.	Silva A, Sampaio R, Pinto E. Patient-specific instrumentation improves tibial component rotation in TKA. Knee Surg Sports Traumatol Arthrosc, 2014, 22(3): 636-642.
42.	Heyse TJ, Tibesku CO. Improved tibial component rotation in TKA using patient-specific instrumentation. Arch Orthop Trauma Surg, 2015, 135(5): 697-701.
43.	Parratte S, Blanc G, Boussemart T, et al. Rotation in total knee arthroplasty: no difference between patient-specific and conventional instrumentation. Knee Surg Sports Traumatol Arthrosc, 2013, 21(10): 2213-2219.

1. Bédard M, Vince KG, Redfern J, et al. Internal rotation of the tibial component is frequent in stiff total knee arthroplasty. Clin Orthop Relat Res, 2011, 469(8): 2346-2355.
2. Kim YH, Park JW, Kim JS, et al. The relationship between the survival of total knee arthroplasty and postoperative coronal, sagittal and rotational alignment of knee prosthesis. Int Orthop, 2014, 38(2): 379-385.
3. Kuriyama S, Ishikawa M, Furu M, et al. Malrotated tibial component increases medial collateral ligament tension in total knee arthroplasty. J Orthop Res, 2014, 32(12): 1658-1666.
4. Osano K, Nagamine R, Todo M, et al. The effect of malrotation of tibial component of total knee arthroplasty on tibial insert during high flexion using a finite element analysis. Scientific World Journal, 2014, 2014: 695028.
5. Schiavone Panni A, Cerciello S, Vasso M, et al. Stiffness in total knee arthroplasty. J Orthop Traumatol, 2009, 10(3): 111-118.
6. Drexler M, Backstein D, Studler U, et al. The medial border of the tibial tuberosity as an auxiliary tool for tibial component rotational alignment during total knee arthroplasty (TKA). Knee Surg Sports Traumatol Arthrosc, 2017, 25(6): 1736-1742.
7. Berger RA, Crossett LS, Jacobs JJ, et al. Malrotation causing patellofemoral complications after total knee arthroplasty. Clin Orthop Relat Res, 1998, (356): 144-153.
8. Nicoll D, Rowley DI. Internal rotational error of the tibial component is a major cause of pain after total knee replacement. J Bone Joint Surg (Br), 2010, 92(9): 1238-1244.
9. Eckhoff DG, Metzger RG, Vandewalle MV. Malrotation associated with implant alignment technique in total knee arthroplasty. Clin Orthop Relat Res, 1995, (321): 28-31.
10. Feczko PZ, Pijls BG, Steijn MJ, et al. Tibial component rotation in total knee arthroplasty. BMC Musculoskelet Disord, 2016, 17: 87.
11. Gromov K, Korchi M, Thomsen MG, et al. What is the optimal alignment of the tibial and femoral components in knee arthroplasty? Acta Orthop, 2014, 85(5): 480-487.
12. Insall JN, Binazzi R, Soudry M, et al. Total knee arthroplasty. Clin Orthop Relat Res, 1985, (192): 13-22.
13. Lawrie CM, Noble PC, Ismaily SK, et al. The flexion-extension axis of the knee and its relationship to the rotational orientation of the tibial plateau. J Arthroplasty, 2011, 26(6 Suppl): 53-58.
14. Yin L, Chen K, Guo L, et al. Knee alignment in the transverse plane during weight-bearing activity and its implication for the tibial rotational alignment in total knee arthroplasty. Clin Biomech (Bristol, Avon), 2015, 30(6): 565-571.
15. Akagi M, Oh M, Nonaka T, et al. An anteroposterior axis of the tibia for total knee arthroplasty. Clin Orthop Relat Res, 2004, (420): 213-219.
16. Howell SM, Chen J, Hull ML. Variability of the location of the tibial tubercle affects the rotational alignment of the tibial component in kinematically aligned total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2013, 21(10): 2288-2295.
17. Tao K, Cai M, Zhu Y, et al. Aligning the tibial component with medial border of the tibial tubercle—is it always right? Knee, 2014, 21(1): 295-298.
18. Incavo SJ, Coughlin KM, Pappas C, et al. Anatomic rotational relationships of the proximal tibia, distal femur, and patella: implications for rotational alignment in total knee arthroplasty. J Arthroplasty, 2003, 18(5): 643-648.
19. Graw BP, Harris AH, Tripuraneni KR, et al. Rotational references for total knee arthroplasty tibial components change with level of resection. Clin Orthop Relat Res, 2010, 468(10): 2734-2738.
20. Heyse TJ, Stiehl JB, Tibesku CO. Measuring tibial component rotation of TKA in MRI: What is reproducible? Knee, 2015, 22(6): 604-608.
21. Rossi R, Bruzzone M, Bonasia DE, et al. Evaluation of tibial rotational alignment in total knee arthroplasty: a cadaver study. Knee Surg Sports Traumatol Arthrosc, 2010, 18(7): 889-893.
22. Uehara K, Kadoya Y, Kobayashi A, et al. Bone anatomy and rotational alignment in total knee arthroplasty. Clin Orthop Relat Res, 2002, (402): 196-201.
23. 余华晨, 温宏, 张宇, 等. Akagi 线作为全膝关节置换胫骨近端假体旋转对线的可靠性研究. 中国骨伤, 2015, 28(10): 884-887.
24. Berhouet J, Beaufils P, Boisrenoult P, et al. Rotational positioning of the tibial tray in total knee arthroplasty: a CT evaluation. Orthop Traumatol Surg Res, 2011, 97(7): 699-704.
25. Forster-Horvath C, Kremo V, Müller-Gerbl M, et al. Using the anatomical tibial axis for total knee arthroplasty alignment may lead to an internal rotation error. Int Orthop, 2015, 39(12): 2347-2353.
26. Martin S, Saurez A, Ismaily S, et al. Maximizing tibial coverage is detrimental to proper rotational alignment. Clin Orthop Relat Res, 2014, 472(1): 121-125.
27. Hirakawa M, Miyazaki M, Ikeda S, et al. Evaluation of the rotational alignment of the tibial component in total knee arthroplasty: position prioritizing maximum coverage. Eur J Orthop Surg Traumatol, 2017, 27(1): 119-124.
28. Stulberg SD, Goyal N. Which tibial tray design achieves maximum coverage and ideal rotation: Anatomic, symmetric, or asymmetric? An MRI-based study. J Arthroplasty, 2015, 30(10): 1839-1841.
29. Baldini A, Indelli PF, DE Luca L, et al. Rotational alignment of the tibial component in total knee arthroplasty: the anterior tibial cortex is a reliable landmark. Joints, 2014, 1(4): 155-160.
30. Benjamin J. Component alignment in total knee arthroplasty. Instr Course Lect, 2006, 55: 405-412.
31. Hernandez-Vaquero D, Noriega-Fernandez A, Fernandez-Carreira JM, et al. Computer-assisted surgery improves rotational positioning of the femoral component but not the tibial component in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2014, 22(12): 3127-3134.
32. Miller MC, Zhang AX, Petrella AJ, et al. The effect of component placement on knee kinetics after arthroplasty with an unconstrained prosthesis. J Orthop Res, 2001, 19(4): 614-620.
33. Ikeuchi M, Yamanaka N, Okanoue Y, et al. Determining the rotational alignment of the tibial component at total knee replacement: a comparison of two techniques. J Bone Joint Surg (Br), 2007, 89(1): 45-49.
34. Tsai TY, Dimitriou D, Liow MH, et al. Three-dimensional imaging analysis of unicompartmental knee arthroplasty evaluated in standing position: Component alignment and in vivo articular contact. J Arthroplasty, 2016, 31(5): 1096-1101.
35. Hetaimish BM, Khan MM, Simunovic N, et al. Meta-analysis of navigation vs conventional total knee arthroplasty. J Arthroplasty, 2012, 27(6): 1177-1182.
36. Matziolis G, Krocker D, Weiss U, et al. A prospective, randomized study of computer-assisted and conventional total knee arthroplasty. Three-dimensional evaluation of implant alignment and rotation. J Bone Joint Surg (Am), 2007, 89(2): 236-243.
37. Kim SH, Lee HJ, Jung HJ, et al. Less femoral lift-off and better femoral alignment in TKA using computer-assisted surgery. Knee Surg Sports Traumatol Arthrosc, 2013, 21(10): 2255-2262.
38. Lombardi AV Jr, Berend KR, Adams JB. Patient-specific approach in total knee arthroplasty. Orthopedics, 2008, 31(9): 927-930.
39. 刘德健, 李彦林, 蔡国锋, 等. 3D 打印截骨导板辅助人工全膝关节置换术早期疗效分析. 中国修复重建外科杂志, 2018, 32(7): 899-905.
40. 孙茂淋, 杨柳, 何锐, 等. 3D 打印导板辅助人工全膝关节置换术后患者步态分析. 中国修复重建外科杂志, 2019, 33(8): 953-959.
41. Silva A, Sampaio R, Pinto E. Patient-specific instrumentation improves tibial component rotation in TKA. Knee Surg Sports Traumatol Arthrosc, 2014, 22(3): 636-642.
42. Heyse TJ, Tibesku CO. Improved tibial component rotation in TKA using patient-specific instrumentation. Arch Orthop Trauma Surg, 2015, 135(5): 697-701.
43. Parratte S, Blanc G, Boussemart T, et al. Rotation in total knee arthroplasty: no difference between patient-specific and conventional instrumentation. Knee Surg Sports Traumatol Arthrosc, 2013, 21(10): 2213-2219.

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Chinese Journal of Reparative and Reconstructive Surgery

Progress in the method of tibial prosthesis rotation alignment in total knee arthroplasty

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