The tibial growth plate as a predictor of the original tibial plateau joint line as a reference for kinematically aligned total knee arthroplasty

Katsuya Nagai, Yasuo Niki, Kengo Harato, Shu Kobayashi, Takeo Nagura, Takayuki Nakamura, Morio Matsumoto, Masaya Nakamura

Research output: Contribution to journalArticle

Abstract

Background: Restoration of the natural joint line is a cornerstone for kinematically aligned total knee arthroplasty (TKA). The purpose of this study was to investigate the relative orientation of the tibial growth plate (GP) with respect to the tibial plateau (TP) for possible application in predicting natural joint line for knees with highly advanced osteoarthritis patient at the time of kinematically aligned TKA. Methods: Images from computed tomography (CT) of 27 normal knees (9 males, 18 females; mean age, 31.6 years) were studied. Geometry of the GP was extracted from CT images, and its moment-of-inertia axes were calculated for the whole GP and the medial and lateral halves. Angular orientations of each GP axis with respect to the TP plane were measured in anatomical coordinates. Results: The TP and GP planes were oriented in 2.3 ± 1.8° of varus and 1.1 ± 1.9° of valgus relative to the tibial mechanical axis, respectively. With respect to the TP plane, the whole GP plane was inclined in 3.4 ± 1.5° of valgus. Orientation of the GP plane differed drastically between medial and lateral halves. The medial GP was in 4.9 ± 2.9° of varus and 1.8 ± 2.5° of anterior inclination, and the lateral half was in 10.4 ± 2.4° of valgus and 18.6 ± 4.0° of anterior inclination relative to the TP. Conclusions: Angular orientation of the original TP plane can be predicted in reference to the GP plane and may provide reasonable guidance for the target bone resection angle of the tibia in kinematically aligned TKA.

Original languageEnglish
Article number4
JournalJournal of Orthopaedic Surgery and Research
Volume13
Issue number1
DOIs
Publication statusPublished - 2018 Jan 8

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Knee Replacement Arthroplasties
Growth Plate
Joints
Tomography
Knee Joint
Tibia
Osteoarthritis
Knee
Bone and Bones

Keywords

  • Growth plate
  • Joint line
  • Kinematically aligned total knee arthroplasty
  • Tibial plateau

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{17f9521a665045d4a5dc1553c6cd3651,
title = "The tibial growth plate as a predictor of the original tibial plateau joint line as a reference for kinematically aligned total knee arthroplasty",
abstract = "Background: Restoration of the natural joint line is a cornerstone for kinematically aligned total knee arthroplasty (TKA). The purpose of this study was to investigate the relative orientation of the tibial growth plate (GP) with respect to the tibial plateau (TP) for possible application in predicting natural joint line for knees with highly advanced osteoarthritis patient at the time of kinematically aligned TKA. Methods: Images from computed tomography (CT) of 27 normal knees (9 males, 18 females; mean age, 31.6 years) were studied. Geometry of the GP was extracted from CT images, and its moment-of-inertia axes were calculated for the whole GP and the medial and lateral halves. Angular orientations of each GP axis with respect to the TP plane were measured in anatomical coordinates. Results: The TP and GP planes were oriented in 2.3 ± 1.8° of varus and 1.1 ± 1.9° of valgus relative to the tibial mechanical axis, respectively. With respect to the TP plane, the whole GP plane was inclined in 3.4 ± 1.5° of valgus. Orientation of the GP plane differed drastically between medial and lateral halves. The medial GP was in 4.9 ± 2.9° of varus and 1.8 ± 2.5° of anterior inclination, and the lateral half was in 10.4 ± 2.4° of valgus and 18.6 ± 4.0° of anterior inclination relative to the TP. Conclusions: Angular orientation of the original TP plane can be predicted in reference to the GP plane and may provide reasonable guidance for the target bone resection angle of the tibia in kinematically aligned TKA.",
keywords = "Growth plate, Joint line, Kinematically aligned total knee arthroplasty, Tibial plateau",
author = "Katsuya Nagai and Yasuo Niki and Kengo Harato and Shu Kobayashi and Takeo Nagura and Takayuki Nakamura and Morio Matsumoto and Masaya Nakamura",
year = "2018",
month = "1",
day = "8",
doi = "10.1186/s13018-017-0708-7",
language = "English",
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journal = "Journal of Orthopaedic Surgery and Research",
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TY - JOUR

T1 - The tibial growth plate as a predictor of the original tibial plateau joint line as a reference for kinematically aligned total knee arthroplasty

AU - Nagai, Katsuya

AU - Niki, Yasuo

AU - Harato, Kengo

AU - Kobayashi, Shu

AU - Nagura, Takeo

AU - Nakamura, Takayuki

AU - Matsumoto, Morio

AU - Nakamura, Masaya

PY - 2018/1/8

Y1 - 2018/1/8

N2 - Background: Restoration of the natural joint line is a cornerstone for kinematically aligned total knee arthroplasty (TKA). The purpose of this study was to investigate the relative orientation of the tibial growth plate (GP) with respect to the tibial plateau (TP) for possible application in predicting natural joint line for knees with highly advanced osteoarthritis patient at the time of kinematically aligned TKA. Methods: Images from computed tomography (CT) of 27 normal knees (9 males, 18 females; mean age, 31.6 years) were studied. Geometry of the GP was extracted from CT images, and its moment-of-inertia axes were calculated for the whole GP and the medial and lateral halves. Angular orientations of each GP axis with respect to the TP plane were measured in anatomical coordinates. Results: The TP and GP planes were oriented in 2.3 ± 1.8° of varus and 1.1 ± 1.9° of valgus relative to the tibial mechanical axis, respectively. With respect to the TP plane, the whole GP plane was inclined in 3.4 ± 1.5° of valgus. Orientation of the GP plane differed drastically between medial and lateral halves. The medial GP was in 4.9 ± 2.9° of varus and 1.8 ± 2.5° of anterior inclination, and the lateral half was in 10.4 ± 2.4° of valgus and 18.6 ± 4.0° of anterior inclination relative to the TP. Conclusions: Angular orientation of the original TP plane can be predicted in reference to the GP plane and may provide reasonable guidance for the target bone resection angle of the tibia in kinematically aligned TKA.

AB - Background: Restoration of the natural joint line is a cornerstone for kinematically aligned total knee arthroplasty (TKA). The purpose of this study was to investigate the relative orientation of the tibial growth plate (GP) with respect to the tibial plateau (TP) for possible application in predicting natural joint line for knees with highly advanced osteoarthritis patient at the time of kinematically aligned TKA. Methods: Images from computed tomography (CT) of 27 normal knees (9 males, 18 females; mean age, 31.6 years) were studied. Geometry of the GP was extracted from CT images, and its moment-of-inertia axes were calculated for the whole GP and the medial and lateral halves. Angular orientations of each GP axis with respect to the TP plane were measured in anatomical coordinates. Results: The TP and GP planes were oriented in 2.3 ± 1.8° of varus and 1.1 ± 1.9° of valgus relative to the tibial mechanical axis, respectively. With respect to the TP plane, the whole GP plane was inclined in 3.4 ± 1.5° of valgus. Orientation of the GP plane differed drastically between medial and lateral halves. The medial GP was in 4.9 ± 2.9° of varus and 1.8 ± 2.5° of anterior inclination, and the lateral half was in 10.4 ± 2.4° of valgus and 18.6 ± 4.0° of anterior inclination relative to the TP. Conclusions: Angular orientation of the original TP plane can be predicted in reference to the GP plane and may provide reasonable guidance for the target bone resection angle of the tibia in kinematically aligned TKA.

KW - Growth plate

KW - Joint line

KW - Kinematically aligned total knee arthroplasty

KW - Tibial plateau

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DO - 10.1186/s13018-017-0708-7

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