Antero-posterior axis of the tibia is a better landmark for tibial component rotation in Oxford medial unicompartmental knee arthroplasty


Aliyev O., Ağır M., Aghazada A., Çeşme D. H. , Kara D., Toprak A., ...More

ORTHOPADIE, 2022 (Peer-Reviewed Journal) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2022
  • Doi Number: 10.1007/s00132-022-04308-8
  • Journal Name: ORTHOPADIE
  • Journal Indexes: Science Citation Index Expanded
  • Keywords: Oxford medial unicondylar knee arthroplasty, Knee, Partial, Unicondylar, Landmark, Tibial axis, Rotation, REPLACEMENT, BEARING, MOBILE, ALIGNMENT

Abstract

Background This retrospective study compares tibial component rotations and radiological and functional outcomes in patients who underwent Oxford medial unicompartmental knee arthroplasty (UKA), using the antero-posterior (AP) tibia axis or anterior superior iliac spine (ASIS) as the landmarks for the direction of the vertical cut. Methods A total of 86 patients, who underwent Oxford medial UKA were divided into 2 groups, each consisting of 43 patients, according to the use of AP axis (group I) or ASIS (group II) as landmarks for the rotation of vertical tibial cut and compared for the radiological and functional outcomes. Tibial component rotations (alpha-angle), involvement of the posterior cruciate ligament (PCL) fossa, and instant bearing position (IBP) were measured on computed tomography (CT) images. Functional outcomes were evaluated using Oxford knee score (OKS) and Knee Society score (KSS). Result The median alpha-angle was significantly smaller in group I than group II (2.5 degrees, range -4-5.5 degrees vs. -6 degrees, range -13-0.5 degrees, p < 0.001). The rates of PCL fossa involvements were 14 (32.6%) and 17 (39.5%, p = 0.7). The median flexion angle of the femoral component (7 degrees vs. 10.5 degrees) and posterior tibial slope (6 degrees vs. 8 degrees) were significantly lower in group I than group II (p = 0.001). All other radiological parameters, preoperative and final OKS and KSS were statistically similar in both groups. Conclusion Taking the AP tibial axis as a landmark for vertical tibial cut rotation provides more neutral tibial component rotation in Oxford medial UKA compared to ASIS; however, this difference may not influence the clinical outcomes.