The Journal of Arthroplasty
Volume 26, Issue 6, Supplement , Pages 53-58.e1, September 2011

The Flexion-Extension Axis of the Knee and its Relationship to the Rotational Orientation of the Tibial Plateau

  • Charles M. Lawrie, BS

      Affiliations

    • Baylor College of Medicine, Houston, Texas
    • ,
  • Philip C. Noble, PhD

      Affiliations

    • Baylor College of Medicine, Houston, Texas
    • The Institute of Orthopedic Research and Education, Houston, Texas
    • Corresponding Author InformationReprint requests: Philip C. Noble, PhD, Professor of Orthopedic Surgery, Baylor College of Medicine, Director of Research, Institute of Orthopedic Research and Education, 6550 Fannin St., Suite 2501, Houston, TX 77030
    • ,
  • Sabir K. Ismaily, BS

      Affiliations

    • The Institute of Orthopedic Research and Education, Houston, Texas
    • ,
  • Drew Stal, BS

      Affiliations

    • The Institute of Orthopedic Research and Education, Houston, Texas
    • ,
  • Steve J. Incavo, MD

      Affiliations

    • The Methodist Hospital, Houston, Texas

Received 13 July 2010; accepted 18 April 2011. published online 04 July 2011.

Abstract 

We measured the optimal rotational alignment of the tibial component with respect to anatomic landmarks. Kinematic data were collected from functional maneuvers simulated in 20 cadaveric knees mounted in a joint simulator. The axis of knee motion was calculated for squatting and lunging activities over the interval of 30° to 90° of knee flexion. We then examined the accuracy and variability of 5 different anatomic axes in predicting the direction of knee motion. No one landmark guaranteed correct alignment of the tibial component and most predictors were highly variable (range, 6°-21°). The most accurate indicators were the medial third of the tibial tubercle (average error: squatting: 3.5° external rotation; lunging: 9.5°), and the medial-lateral axis of the resected tibial surface (6.7° and 1.1° internal rotation). The correct alignment of the tibial component can be best achieved by splitting the difference between these landmarks to eliminate placement of the component in excessive external and excessive internal rotation.

Keywords: flexion-extension, rotational orientation, tibial plateau

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 Supplementary material available at www.arthroplastyjournal.org.

 The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.04.026.

 Work performed at the Institute of Orthopedic Research and Education

PII: S0883-5403(11)00210-5

doi:10.1016/j.arth.2011.04.026

The Journal of Arthroplasty
Volume 26, Issue 6, Supplement , Pages 53-58.e1, September 2011

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