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Mid-sulcus line predictive guide for tibial mechanical axis during TKA

Written By : Dr Supreeth D R |Medically Reviewed By : Dr. Kamal Kant Kohli   |  
Mid-sulcus line predictive guide for tibial mechanical axis during TKA
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Alok Umre et al found in a study that-"Mid-sulcus line can be used as an additional anatomical landmark to guide the tibial resection and thereby achieve appropriate coronal alignment in primary TKAs without any extra-articular deformity."

Achieving appropriate alignment of components in total knee arthroplasty (TKA) is essential for optimal functional outcomes as well as implant longevity. Performing TKA in the absence of a computer-assisted navigation system (CANS) mandates the use of accurate anatomical landmarks for achieving appropriate alignment. In this study, authors have evaluated the reliability of ‘mid-sulcus line’ as an anatomical landmark to guide tibial resection, with the intra-operative help of CANS.

The study was conducted at Department of Orthopaedics, Arogyam Superspeciality Hospital, Nagpur, India. The article has been published in ‘The Knee’ journal. A total of 322 patients undergoing primary TKA (excluding previously operated limbs and limbs with extra-articular deformities of tibia or femur) using CANS were included in the study. After resecting ACL, the mid-sulcus line was drawn with a cautery tip. The authors hypothesized that if tibial cut was made perpendicular to the mid-sulcus line, coronal alignment of the tibial component would be along the neutral mechanical axis. This was evaluated intra-operatively with the help of CANS.

Key findings of the study were:

• A total of 279 patients were found to have pre-operative varus alignment with mean deformity of 5.60 (range, 0.5–260). Forty-three patients were found to have pre-operative valgus alignment with mean deformity of 5.20 (range, 0.5–180).

• Of 322 knees, identification of the ‘mid-sulcus line’ was possible in 312 knees.

• The mean angle between the tibial alignment defined by mid-sulcus line and the neutral mechanical axis was found to be 0.450 (range, 0–1.50) (P < 0.05).

• In all of the 312 knees, the tibial alignment defined by mid-sulcus line was found to be within 30 of the neutral mechanical axis (confidence interval: 0.4100, 0.4910).

Further reading:

Is mid-sulcus line a predictive guide for tibial mechanical axis during total knee arthroplasty? A. Umre, O. Wakde and R. Meghare The Knee 41 (2023) 373–379 https://doi.org/10.1016/j.knee.2023.02.003

Mid-sulcus lineTibial mechanical axisTotal knee arthroplastyThe KneeAlok Umre et al.
Source : The Knee
Dr Supreeth D R
Dr Supreeth D R

    MBBS, Dip. Ortho, DNB ortho, MNAMS

    Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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