Does Tibial Slope Affect Perception of Coronal Alignment on a Standing Anteroposterior Radiograph?

Adam J. Schwartz, Bheeshma Ravi, Mark J. Kransdorf, Henry D. Clarke

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: A standing anteroposterior (AP) radiograph is commonly used to evaluate coronal alignment following total knee arthroplasty (TKA). The impact of coronal alignment on TKA outcomes is controversial, perhaps due to variability in imaging and/or measurement technique. We sought to quantify the effect of image rotation and tibial slope on coronal alignment. Methods: Using a standard extramedullary tibial alignment guide, 3 cadaver legs were cut to accept a tibial tray at 0°, 3°, and 7° of slope. A computed tomography scan of the entire tibia was obtained for each specimen to confirm neutral coronal alignment. Images were then obtained at progressive 10° intervals of internal and external rotation up to 40° maximum in each direction. Images were then randomized and 5 blinded TKA surgeons were asked to determine coronal alignment. Continuous data values were transformed to categorical data (neutral [0], valgus [L], and varus [R]). Results: Each 10° interval of external rotation of a 7° sloped tibial cut (or relative internal rotation of a tibial component viewed in the AP plane) resulted in perception of an additional 0.75° of varus. Conclusion: The slope of the proximal tibia bone cut should be taken into account when measuring coronal alignment on a standing AP radiograph.

Original languageEnglish (US)
JournalJournal of Arthroplasty
DOIs
StateAccepted/In press - Jul 15 2016

Keywords

  • Alignment
  • Imaging
  • Rotation
  • Slope
  • Tibia
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Fingerprint Dive into the research topics of 'Does Tibial Slope Affect Perception of Coronal Alignment on a Standing Anteroposterior Radiograph?'. Together they form a unique fingerprint.

  • Cite this