Research progress on the measurement and positioning method of tibial platform camber angle in unicompartmental knee arthroplasty
Guo Shuxin1, Dai Siming2, Guan Shikun1, Liu Ning1
1Department of Orthopedics, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China; 2Department of Rheumatology, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
Abstract：Objective This study aimed to summarize the research progress on the measurement and positioning of tibial platform tilt angle (PTS) in unicompartmental knee arthroplasty(UKA). Methods In the present study, in PubMed and other databases of CNKI, "膝关节单髁置换术""胫骨平台后倾角" and "unicompartmental knee arthroplasty" "posterior tibial slope" are used as Chinese and English keywords. A total of 87 relevant literatures published from January 2017 to July 2023 are included. Those whose content is inconsistent, the quality is low, the duplicate research evidence is not high, and the full text cannot be obtained are excluded and 37 literatures are searched and finally included to summarize the significance of PTS in UKA and the relevant research results on the measurement of PTS and intraoperative localization methods. Results It was important to obtain good PTS during UKA surgery for soft tissue balance and range of motion of the knee. MRI and CT are the most accurate methods used to measure PTS. X-ray-based tibial proximal anatomical axis (TPAA) reference method, anterior tibial cortex (ATC) reference method, and posterior tibial cortex reference method are economical and convenient to use. TPAA can be best used as a unified measurement method, and ATC is the preferred method for follow-up and extramedullary guidance. Traditional UKA intraoperative PTS mostly relies on extramedullary positioning rods for empirical measurement, but the accuracy is low. Improved methods such as new osteotomy guide rod reference method, anteromedial tibial platform reference method, and probe method effectively improve the accuracy of intraoperative PTS positioning. Digital orthopedic technologies such as augmented reality technology, computer navigation, robot assistance and patient specific instrumentation osteotomy guide plate can also improve the positioning accuracy of PTS, which is the direction of precision medicine in the future. Conclusion Restoring the original PTS in patients during UKA surgery is of great significance. The application of advanced methods for osteotomy can effectively improve the accuracy and clinical effect of surgery through accurate preoperative measurement and positioning method.
郭蜀新, 代思明, 管士坤, 刘宁. 膝单髁置换术中胫骨平台后倾角测量和定位方法的研究进展[J]. 中华解剖与临床杂志, 2024, 29(3): 202-206.
Guo Shuxin, Dai Siming, Guan Shikun, Liu Ning. Research progress on the measurement and positioning method of tibial platform camber angle in unicompartmental knee arthroplasty. Chinese Journal of Anatomy and Clinics, 2024, 29(3): 202-206.
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