Intraoperative reliability of the tibial anteroposterior axis “Akagi's Line” in total knee arthroplasty

作者：Kohei Kawaguchi, Ryota Yamagami, Kenichi Kono, Tomofumi Kage, Ryo Murakami, Takahiro Arakawa, Hiroshi Inui, Shuji Taketomi, Sakae Tanaka · 发表于：Journal of Experimental Orthopaedics · 年份：2024 · DOI：10.1002/jeo2.12020 · 被引用次数：8 · 研究领域：Total Knee Arthroplasty Outcomes、Knee injuries and reconstruction techniques、Orthopaedic implants and arthroplasty

Purpose: The tibial anatomical anteroposterior (AP) axis "Akagi's line" was originally defined on computed tomography (CT) in total knee arthroplasty (TKA); however, its intraoperative reproducibility remains unknown. This study aimed to evaluate the intraoperative reproducibility of the Akagi's line and its effect on postoperative clinical outcomes. Methods: This prospective study included 171 TKAs. The rotational angle of the intraoperative Akagi's line relative to the original Akagi's line (RAA) defined on CT was measured. The RAA was calculated based on the tibial component rotational angles relative to the intraoperative Akagi's line measured using the navigation system and CT. The effects of RAA on postoperative clinical outcomes and rotational alignments of components were also evaluated. Results: The mean absolute RAA (standard deviation) value was 5.5° (3.9°). The range of RAA was 22° internal rotation to 16° external rotation. Intraoperative Akagi's line outliers (RAA > 10°) were observed in 14% of the knees (24 knees). In outlier analysis, the tibial component rotation angle was externally rotated 6.5° (5.6°) in the outlier group and externally rotated 3.7° (4.2°) in the nonoutlier group (≤10°), with a significant difference between the two groups. Additionally, the outlier group (RAA > 10°) showed lower postoperative clinical outcomes. Conclusion: The original Akagi's line defined on CT showed insufficient reproducibility intraoperatively. The poor intraoperative ...