Is the Medial Wall of the Intercondylar Notch Useful for Tibial Rotational Reference in Unicompartmental Knee Arthroplasty?
Background It is difficult to implant components in the correct rotational position in the narrow operating field in a unicompartmental knee arthroplasty. Although no rotational reference has been confirmed for unicompartmental knee arthroplasty, the AP axis of the tibia may serve as a reference for...
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| Veröffentlicht in: | Clinical orthopaedics and related research 2012-04, Vol.470 (4), p.1177-1184 |
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| creator | Kawahara, Shinya Matsuda, Shuichi Okazaki, Ken Tashiro, Yasutaka Iwamoto, Yukihide |
| description | Background
It is difficult to implant components in the correct rotational position in the narrow operating field in a unicompartmental knee arthroplasty. Although no rotational reference has been confirmed for unicompartmental knee arthroplasty, the AP axis of the tibia may serve as a reference for unicompartmental knee arthroplasty and TKA. However, it is difficult to identify the AP axis during unicompartmental knee arthroplasty, especially with the tibia first-cut technique.
Questions/purposes
We explored whether the medial wall of the intercondylar notch could be useful for the tibial rotational reference as an alternative to the AP axis in unicompartmental knee arthroplasty.
Methods
We scanned the knees of 24 healthy Asian patients (45 knees) at a flexion angle of 90º using open MRI, then measured the angle between the AP axis and the medial wall of the notch. We determined whether the origins of the ACL and PCL were located lateral to the line on the medial wall of the notch and whether the mediolateral dimension of the bone cut surface of the medial tibial plateau was wide enough relative to the AP dimension to use the commercially available unicompartmental knee arthroplasty tibial components when the tibia was cut parallel to the medial wall of the notch.
Results
At 90º flexion the medial wall of the notch was externally rotated 0.1º ± 4.4º relative to the AP axis. In all knees, the ACL and PCL were located lateral to the line on the medial wall of the notch. The mediolateral dimension of the bone cut surface was wide enough to use the commercially available tibial components.
Conclusions
At 90º flexion the medial wall of the intercondylar notch is almost parallel to the AP axis of the tibia at and we believe a reasonable candidate for a rotational reference of tibial placement in unicompartmental knee arthroplasty. This landmark would need to be confirmed in other populations and in patients with osteoarthritis. |
| doi_str_mv | 10.1007/s11999-011-2138-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3293949</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>926646891</sourcerecordid><originalsourceid>FETCH-LOGICAL-c565t-3b6b6c82fd9e0a54a2ac40f90996ded614fc0e39bc3e7c0e88bca3888b9a092a3</originalsourceid><addsrcrecordid>eNp1kV1rVDEQhoModq3-AG8kIOLV0Xycr9xYSvFjsSpIF70LOTmTbko2WZMc6eKfN8ddaxW8mknmmXcmeRF6TMkLSkj3MlEqhKgIpRWjvK-u76AFbVhfUcrZXbQghIhKMPr1CD1I6aoced2w--iIMUIbIfoF-rFMOK8Bf4DRKoe_KOdwML-ulj5D1MGPO6ci_hiyXuNVAjM5bELEF3aYOz6HrLINfk7BQASvAVuPV97qsNmqmDfgc6m-9wD4NOZ1DFunUt6dPET3jHIJHh3iMVq9eX1x9q46__R2eXZ6XummbXLFh3Zodc_MKICoplZM6ZoYQYRoRxhbWhtNgItBc-hK1veDVrwvQSgimOLH6NVedzsNGxh12ScqJ7fRblTcyaCs_Lvi7Vpehu-SM8FFLYrA84NADN8mSFlubNLgnPIQpiQFa9u67QUt5NN_yKswxfI5SVLCaFvk-KxH95SOIaUI5mYXSuTsrNw7K4uzcnZWXpeeJ7cfcdPx28oCPDsAKmnlTFRe2_SHa7qu6-k8nO25VEr-EuLtFf83_SfIlr67</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1021639439</pqid></control><display><type>article</type><title>Is the Medial Wall of the Intercondylar Notch Useful for Tibial Rotational Reference in Unicompartmental Knee Arthroplasty?</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kawahara, Shinya ; Matsuda, Shuichi ; Okazaki, Ken ; Tashiro, Yasutaka ; Iwamoto, Yukihide</creator><creatorcontrib>Kawahara, Shinya ; Matsuda, Shuichi ; Okazaki, Ken ; Tashiro, Yasutaka ; Iwamoto, Yukihide</creatorcontrib><description>Background
It is difficult to implant components in the correct rotational position in the narrow operating field in a unicompartmental knee arthroplasty. Although no rotational reference has been confirmed for unicompartmental knee arthroplasty, the AP axis of the tibia may serve as a reference for unicompartmental knee arthroplasty and TKA. However, it is difficult to identify the AP axis during unicompartmental knee arthroplasty, especially with the tibia first-cut technique.
Questions/purposes
We explored whether the medial wall of the intercondylar notch could be useful for the tibial rotational reference as an alternative to the AP axis in unicompartmental knee arthroplasty.
Methods
We scanned the knees of 24 healthy Asian patients (45 knees) at a flexion angle of 90º using open MRI, then measured the angle between the AP axis and the medial wall of the notch. We determined whether the origins of the ACL and PCL were located lateral to the line on the medial wall of the notch and whether the mediolateral dimension of the bone cut surface of the medial tibial plateau was wide enough relative to the AP dimension to use the commercially available unicompartmental knee arthroplasty tibial components when the tibia was cut parallel to the medial wall of the notch.
Results
At 90º flexion the medial wall of the notch was externally rotated 0.1º ± 4.4º relative to the AP axis. In all knees, the ACL and PCL were located lateral to the line on the medial wall of the notch. The mediolateral dimension of the bone cut surface was wide enough to use the commercially available tibial components.
Conclusions
At 90º flexion the medial wall of the intercondylar notch is almost parallel to the AP axis of the tibia at and we believe a reasonable candidate for a rotational reference of tibial placement in unicompartmental knee arthroplasty. This landmark would need to be confirmed in other populations and in patients with osteoarthritis.</description><identifier>ISSN: 0009-921X</identifier><identifier>EISSN: 1528-1132</identifier><identifier>DOI: 10.1007/s11999-011-2138-x</identifier><identifier>PMID: 22015998</identifier><identifier>CODEN: CORTBR</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Adult ; Arthroplasty, Replacement, Knee - methods ; Basic Research ; Biological and medical sciences ; Conservative Orthopedics ; Diseases of the osteoarticular system ; Female ; Femur - diagnostic imaging ; Femur - surgery ; Humans ; Knee ; Knee Joint - diagnostic imaging ; Knee Joint - surgery ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Orthopedic surgery ; Orthopedics ; Osteoarthritis, Knee - diagnostic imaging ; Osteoarthritis, Knee - surgery ; Radiography ; Range of Motion, Articular ; Sports Medicine ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgical Orthopedics ; Tibia - diagnostic imaging ; Tibia - surgery</subject><ispartof>Clinical orthopaedics and related research, 2012-04, Vol.470 (4), p.1177-1184</ispartof><rights>The Association of Bone and Joint Surgeons® 2011</rights><rights>2015 INIST-CNRS</rights><rights>The Association of Bone and Joint Surgeons 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c565t-3b6b6c82fd9e0a54a2ac40f90996ded614fc0e39bc3e7c0e88bca3888b9a092a3</citedby><cites>FETCH-LOGICAL-c565t-3b6b6c82fd9e0a54a2ac40f90996ded614fc0e39bc3e7c0e88bca3888b9a092a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3293949/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3293949/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25777819$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22015998$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kawahara, Shinya</creatorcontrib><creatorcontrib>Matsuda, Shuichi</creatorcontrib><creatorcontrib>Okazaki, Ken</creatorcontrib><creatorcontrib>Tashiro, Yasutaka</creatorcontrib><creatorcontrib>Iwamoto, Yukihide</creatorcontrib><title>Is the Medial Wall of the Intercondylar Notch Useful for Tibial Rotational Reference in Unicompartmental Knee Arthroplasty?</title><title>Clinical orthopaedics and related research</title><addtitle>Clin Orthop Relat Res</addtitle><addtitle>Clin Orthop Relat Res</addtitle><description>Background
It is difficult to implant components in the correct rotational position in the narrow operating field in a unicompartmental knee arthroplasty. Although no rotational reference has been confirmed for unicompartmental knee arthroplasty, the AP axis of the tibia may serve as a reference for unicompartmental knee arthroplasty and TKA. However, it is difficult to identify the AP axis during unicompartmental knee arthroplasty, especially with the tibia first-cut technique.
Questions/purposes
We explored whether the medial wall of the intercondylar notch could be useful for the tibial rotational reference as an alternative to the AP axis in unicompartmental knee arthroplasty.
Methods
We scanned the knees of 24 healthy Asian patients (45 knees) at a flexion angle of 90º using open MRI, then measured the angle between the AP axis and the medial wall of the notch. We determined whether the origins of the ACL and PCL were located lateral to the line on the medial wall of the notch and whether the mediolateral dimension of the bone cut surface of the medial tibial plateau was wide enough relative to the AP dimension to use the commercially available unicompartmental knee arthroplasty tibial components when the tibia was cut parallel to the medial wall of the notch.
Results
At 90º flexion the medial wall of the notch was externally rotated 0.1º ± 4.4º relative to the AP axis. In all knees, the ACL and PCL were located lateral to the line on the medial wall of the notch. The mediolateral dimension of the bone cut surface was wide enough to use the commercially available tibial components.
Conclusions
At 90º flexion the medial wall of the intercondylar notch is almost parallel to the AP axis of the tibia at and we believe a reasonable candidate for a rotational reference of tibial placement in unicompartmental knee arthroplasty. This landmark would need to be confirmed in other populations and in patients with osteoarthritis.</description><subject>Adult</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Basic Research</subject><subject>Biological and medical sciences</subject><subject>Conservative Orthopedics</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>Femur - diagnostic imaging</subject><subject>Femur - surgery</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Joint - diagnostic imaging</subject><subject>Knee Joint - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedic surgery</subject><subject>Orthopedics</subject><subject>Osteoarthritis, Knee - diagnostic imaging</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Radiography</subject><subject>Range of Motion, Articular</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgical Orthopedics</subject><subject>Tibia - diagnostic imaging</subject><subject>Tibia - surgery</subject><issn>0009-921X</issn><issn>1528-1132</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kV1rVDEQhoModq3-AG8kIOLV0Xycr9xYSvFjsSpIF70LOTmTbko2WZMc6eKfN8ddaxW8mknmmXcmeRF6TMkLSkj3MlEqhKgIpRWjvK-u76AFbVhfUcrZXbQghIhKMPr1CD1I6aoced2w--iIMUIbIfoF-rFMOK8Bf4DRKoe_KOdwML-ulj5D1MGPO6ci_hiyXuNVAjM5bELEF3aYOz6HrLINfk7BQASvAVuPV97qsNmqmDfgc6m-9wD4NOZ1DFunUt6dPET3jHIJHh3iMVq9eX1x9q46__R2eXZ6XummbXLFh3Zodc_MKICoplZM6ZoYQYRoRxhbWhtNgItBc-hK1veDVrwvQSgimOLH6NVedzsNGxh12ScqJ7fRblTcyaCs_Lvi7Vpehu-SM8FFLYrA84NADN8mSFlubNLgnPIQpiQFa9u67QUt5NN_yKswxfI5SVLCaFvk-KxH95SOIaUI5mYXSuTsrNw7K4uzcnZWXpeeJ7cfcdPx28oCPDsAKmnlTFRe2_SHa7qu6-k8nO25VEr-EuLtFf83_SfIlr67</recordid><startdate>20120401</startdate><enddate>20120401</enddate><creator>Kawahara, Shinya</creator><creator>Matsuda, Shuichi</creator><creator>Okazaki, Ken</creator><creator>Tashiro, Yasutaka</creator><creator>Iwamoto, Yukihide</creator><general>Springer-Verlag</general><general>Springer</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20120401</creationdate><title>Is the Medial Wall of the Intercondylar Notch Useful for Tibial Rotational Reference in Unicompartmental Knee Arthroplasty?</title><author>Kawahara, Shinya ; Matsuda, Shuichi ; Okazaki, Ken ; Tashiro, Yasutaka ; Iwamoto, Yukihide</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c565t-3b6b6c82fd9e0a54a2ac40f90996ded614fc0e39bc3e7c0e88bca3888b9a092a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Arthroplasty, Replacement, Knee - methods</topic><topic>Basic Research</topic><topic>Biological and medical sciences</topic><topic>Conservative Orthopedics</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>Femur - diagnostic imaging</topic><topic>Femur - surgery</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Joint - diagnostic imaging</topic><topic>Knee Joint - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedic surgery</topic><topic>Orthopedics</topic><topic>Osteoarthritis, Knee - diagnostic imaging</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>Radiography</topic><topic>Range of Motion, Articular</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgical Orthopedics</topic><topic>Tibia - diagnostic imaging</topic><topic>Tibia - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kawahara, Shinya</creatorcontrib><creatorcontrib>Matsuda, Shuichi</creatorcontrib><creatorcontrib>Okazaki, Ken</creatorcontrib><creatorcontrib>Tashiro, Yasutaka</creatorcontrib><creatorcontrib>Iwamoto, Yukihide</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical orthopaedics and related research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kawahara, Shinya</au><au>Matsuda, Shuichi</au><au>Okazaki, Ken</au><au>Tashiro, Yasutaka</au><au>Iwamoto, Yukihide</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is the Medial Wall of the Intercondylar Notch Useful for Tibial Rotational Reference in Unicompartmental Knee Arthroplasty?</atitle><jtitle>Clinical orthopaedics and related research</jtitle><stitle>Clin Orthop Relat Res</stitle><addtitle>Clin Orthop Relat Res</addtitle><date>2012-04-01</date><risdate>2012</risdate><volume>470</volume><issue>4</issue><spage>1177</spage><epage>1184</epage><pages>1177-1184</pages><issn>0009-921X</issn><eissn>1528-1132</eissn><coden>CORTBR</coden><abstract>Background
It is difficult to implant components in the correct rotational position in the narrow operating field in a unicompartmental knee arthroplasty. Although no rotational reference has been confirmed for unicompartmental knee arthroplasty, the AP axis of the tibia may serve as a reference for unicompartmental knee arthroplasty and TKA. However, it is difficult to identify the AP axis during unicompartmental knee arthroplasty, especially with the tibia first-cut technique.
Questions/purposes
We explored whether the medial wall of the intercondylar notch could be useful for the tibial rotational reference as an alternative to the AP axis in unicompartmental knee arthroplasty.
Methods
We scanned the knees of 24 healthy Asian patients (45 knees) at a flexion angle of 90º using open MRI, then measured the angle between the AP axis and the medial wall of the notch. We determined whether the origins of the ACL and PCL were located lateral to the line on the medial wall of the notch and whether the mediolateral dimension of the bone cut surface of the medial tibial plateau was wide enough relative to the AP dimension to use the commercially available unicompartmental knee arthroplasty tibial components when the tibia was cut parallel to the medial wall of the notch.
Results
At 90º flexion the medial wall of the notch was externally rotated 0.1º ± 4.4º relative to the AP axis. In all knees, the ACL and PCL were located lateral to the line on the medial wall of the notch. The mediolateral dimension of the bone cut surface was wide enough to use the commercially available tibial components.
Conclusions
At 90º flexion the medial wall of the intercondylar notch is almost parallel to the AP axis of the tibia at and we believe a reasonable candidate for a rotational reference of tibial placement in unicompartmental knee arthroplasty. This landmark would need to be confirmed in other populations and in patients with osteoarthritis.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>22015998</pmid><doi>10.1007/s11999-011-2138-x</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Adult Arthroplasty, Replacement, Knee - methods Basic Research Biological and medical sciences Conservative Orthopedics Diseases of the osteoarticular system Female Femur - diagnostic imaging Femur - surgery Humans Knee Knee Joint - diagnostic imaging Knee Joint - surgery Male Medical sciences Medicine Medicine & Public Health Orthopedic surgery Orthopedics Osteoarthritis, Knee - diagnostic imaging Osteoarthritis, Knee - surgery Radiography Range of Motion, Articular Sports Medicine Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgical Orthopedics Tibia - diagnostic imaging Tibia - surgery |
| title | Is the Medial Wall of the Intercondylar Notch Useful for Tibial Rotational Reference in Unicompartmental Knee Arthroplasty? |
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