Can tibial coverage in total knee replacement be reliably evaluated with three-dimensional image-based digital templating?

Fuente:  http://www.bjr.boneandjoint.org.uk/content/2/1/1.full

Can tibial coverage in total knee replacement be reliably evaluated with three-dimensional image-based digital templating?

1. A. J. Costa, FRCSC, Orthopaedic Surgeon1 , 
2. S. Lustig, MD, PhD, Orthopaedic Surgeon1 , 
3. C. J. Scholes, PhD, Director of Research1 ,
4. J-C. Balestro, MD, Orthopaedic Surgeon1 , 
5. M. Fatima, BEng, Engineer1  and 
6. D. A. Parker, FRACS, Consultant Orthopaedic Surgeon1

+Author Affiliations

1. ¹Sydney Orthopaedic Research Institute, Chatswood, New South Wales, Australia.

1. Correspondence should be sent to Dr C. J. Scholes; e-mail:cscholes@sori.com.au

1. Author contributions: A. J. Costa: Data collection, Writing the paper
   S. Lustig: Data collection, Writing the paper
   C. J. Scholes: Concept development, Statistical analysis, Writing the paper
   J-C. Balestro: Data collection, Manuscript approval
   M. Fatima: Data collection, Data analysis, Writing the paper
   D. A. Parker: Concept development, Manuscript approval

Abstract

Objectives There remains a lack of data on the reliability of methods to estimate tibial coverage achieved during total knee replacement. In order to address this gap, the intra- and interobserver reliability of a three-dimensional (3D) digital templating method was assessed with one symmetric and one asymmetric prosthesis design.

Methods A total of 120 template procedures were performed according to specific rotational and over-hang criteria by three observers at time zero and again two weeks later. Total and sub-region coverage were calculated and the reliability of the templating and measurement method was evaluated.

Results Excellent intra- and interobserver reliability was observed for total coverage, when minimal component overhang (intraclass correlation coefficient (ICC) = 0.87) or no component overhang (ICC = 0.92) was permitted, regardless of rotational restrictions.

Conclusions Measurement of tibial coverage can be reliable using the templating method described even if the rotational axis selected still has a minor influence.

• Knee
 
• Digital templating
 
• Reliability
 
• Tibial coverage
• Arthroplasty
 
• Baseplate

Footnotes

• Funding statement: Financial support for this study was provided by the Sydney Orthopaedic Research Institute. Patient imaging was originally funded by Stryker South Pacific for an unrelated study.
• ICMJE Conflict of Interest: None declared
• ©2013 British Editorial Society of Bone and Joint Surgery. This is an open-access article distributed under the terms of the Creative Commons Attributions licence, which permits unrestricted use, distribution, and reproduction in any medium, but not for commercial gain, provided the original author and source are credited.

• Received August 22, 2012.
• Accepted October 29, 2012.

• ©2013 British Editorial Society of Bone and Joint Surgery