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Relationship of the tibial tuberosity (TT) position, tibial tuberositytrochlear groove (TT-TG) distance, and internal and external rotation of the knee under weight-bearing conditions

5 pagesPublished: October 27, 2019

Abstract

An important factor which influences the clinical outcome of total knee arthroplasty (TKA) is the internal/external rotational alignment of the femoral and tibial components. A rotational error of few degrees has been found to be clinically important and linked to anterior knee pain [1] and patellofemoral problems [2]. A commonly used reference to align the tibial component rotationally is the tibial tuberosity (TT). However, Howell et al. [3] showed that the medial/lateral TT position varies strongly between patients and represents an unreliable landmark during (passive) kinematic component alignment. Thereby, passive kinematics differs from active kinematics [4,5]. For example, under weight-bearing conditions the magnitude of internal/external rotation is greater and occurs earlier [6]. In the active situation, a relative internal rotation of the tibial component increases the Q-angle with a change in the force vector of the extensor mechanism.
An established radiographic measure to quantify the relative rotational alignment of the femur and tibia in extension is the tibial tuberosity-trochlear groove (TT-TG) distance. It has been measured recently at different flexion angles under non-weight-bearing conditions [7]. However, Izadpanah et al. [8] reported that it also depends on weight-bearing. Hence, the complex function of the extensor mechanism in terms of the relationship between TT position, TT-TG distance, and internal/external rotation under weight-bearing conditions is still unknown and accordingly component rotational alignment targets.
The aim of the study was to investigate the relationship between TT position, TT-TG distance, and internal/external rotation of the knee in the active (weight-bearing) situation.

Keyphrases: Active kinematics, Biomechanics, Component alignment, knee, Tibial tuberosity-trochlear groove distance, Total knee arthroplasty, Tuberositas tibiae, Weight bearing

In: Patrick Meere and Ferdinando Rodriguez Y Baena (editors). CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 3, pages 26--30

Links:
BibTeX entry
@inproceedings{CAOS2019:Relationship_of_tibial_tuberosity,
  author    = {Malte Asseln and Patrick Meere and Peter Walker and Klaus Radermacher},
  title     = {Relationship of the tibial tuberosity (TT) position, tibial tuberositytrochlear groove (TT-TG) distance, and internal and external rotation of the knee under weight-bearing conditions},
  booktitle = {CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Patrick Meere and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {3},
  pages     = {26--30},
  year      = {2019},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {https://easychair.org/publications/paper/sKrn},
  doi       = {10.29007/q54g}}
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