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Mid-sulcus line likely effective in surgical planning of tibial resection during TKA
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ORLANDO, Fla. — The mid-sulcus line has been identified as a landmark guide that can aid orthopedic surgeons in planning tibial resection in patients who undergo total knee arthroplasty, according to results of a study presented at the American Academy of Orthopaedic Surgeons Annual Meeting, here.
“The mid-sulcus line is an easily identifiable tibial landmark,” David F. Dalury, MD, said. “It is highly predictable of tibial mechanical axis. It can help surgeons avoid malrotation and particularly target mechanical alignment in total knee replacement.”
Dalury and colleagues evaluated the CT scans relating to preoperative planning for custom cutting blocks for total knee arthroplasty (TKA) in 107 patients with osteoarthritic knees. Average patient age was 65 years and average BMI was 33. Limb alignment was varus for 88 patients. A mid-sulcus line was drawn along the surface of the tibia through the sulcus formed by the dual tibial spines while a second perpendicular line was drawn on the anterior surface of the tibia, intersecting the medial third of the tubercle. Researchers then compared the tibial mechanical axis to the anterior extension of the second line.
Researchers made clear identification of the mid-sulcus line in all cases. When the line was used as a landmark for surgical planning, it was observed to be within 3° of a neutral mechanical axis for 105 patients and within 4° in all the patients in the study. The line was within 1° of neutral mechanical axis in 77 of patients. — by Christian Ingram
Reference:
Dalury DF, et al. Paper #61. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 1-5, 2016; Orlando, Fla.
Disclosure: Dalury reports no relevant financial disclosures.