Soft tissue landmarks for tibial baseplate rotational alignment in total knee arthroplasty: a cadaveric study

Eseonu, O., Mactier, M., Ferguson, E. , Quondamatteo, F., Blyth, M. and Jones, B. (2022) Soft tissue landmarks for tibial baseplate rotational alignment in total knee arthroplasty: a cadaveric study. Clinical Anatomy, 35(8), pp. 11107-1113. (doi: 10.1002/ca.23921) (PMID:35668648)

Abstract

Introduction: The tip of the tibial tubercle (TTT) is used to assess tibial baseplate rotation in total knee arthroplasty (TKA) however it can be difficult to palpate and visualise intra-operatively. Several more easily accessible soft-tissue structures have been proposed as intra-operative assessments, including the patellar tendon's medial border (MBPT) and the junction of the medial third of the patellar tendon (mt-PT). No studies have described the relationship between the TTT and these proposed landmarks. The aims of the study were to 1) determine the relationship of the soft tissue landmarks to the TTT, and 2) identify any sex differences in these measures. Materials and Methods: Measurements of the position of these soft tissue landmarks relative to the TTT were made on 56 cadaveric knees (28 female) by two observers at the level of the standard tibial cut (10 mm distal to the lateral tibial plateau). The results obtained were compared by sex and side. Results: On average, 50.7% (SD 6.79, range 33.1 - 63.1%) of the patellar tendon footprint was medial to the TTT. There were no significant differences between the sexes or left and right lower limbs. However, there was large variability in the position of all the soft tissue landmarks relative to the TTT. Conclusions: The results indicate that on average, the patellar tendon footprint is evenly spread around the TTT. However, there is a large variability in the anatomical relationship between the soft tissue landmarks and the TTT. Caution is advised if relying on these structures intra-operatively.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Eseonu, Mr Onyedikachi and Jones, Mr Bryn and Quondamatteo, Prof Fabio and Ferguson, Dr Eilidh and Mactier, Dr Mhairi
• Authors: Eseonu, O., Mactier, M., Ferguson, E., Quondamatteo, F., Blyth, M., and Jones, B.
• Subjects: Q Science > QM Human anatomy; R Medicine > RD Surgery
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Clinical Anatomy
• Publisher: Wiley
• ISSN: 0897-3806
• ISSN (Online): 1098-2353
• Published Online: 06 June 2022
• Copyright Holders: Copyright © 2022 John Wiley and Sons Ltd
• First Published: First published in Clinical Anatomy 35(8): 1107-1113
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher