Reliability evaluation of inter-eminence line,Akagi and Dalury lines for intraoperative tibial rotation: An osteology-based study |
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Authors: | Rhodri Williams Amal Thomas Stefan Bajada Tony Antonios Rhidian Morgan-Jones Jelena Bekvalac Philip Adds |
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Affiliation: | 1. Department of Trauma and Orthopaedics, Hywel Dda University NHS Health Board, Carmarthen, Wales, UK;2. Institute of Medical and Biomedical Education (Anatomy), St George''s University of London, London, UK;3. Department of Trauma and Orthopaedics, Guy''s & St Thomas'' NHS Foundation Trust, London, UK;4. Department of Trauma and Orthopaedics, Cardiff and Vale NHS University Health Board, Cardiff, Wales, UK;5. Centre for Human Bioarchaeology, Museum of London, London, UK |
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Abstract: | BackgroundThis large osteology study examined the reliability, reproducibility and correlation between previously described tibial tray rotation alignment lines (including Akagi and Dalury lines). In addition, it described a novel inter-eminence line utilising the tibial plateau inter-condylar eminences as a landmark.MethodsA total of 214 post-medieval (18–19th centuries) skeletal tibia were examined. The inter/intra-observer variation and correlation between reference lines were measured.ResultsInter-observer reproducibility was excellent and there were no differences between Akagi, Dalury, and inter-eminence lines. Similarly, intra-observer reliability was excellent for Akagi, Dalury, and inter-eminence lines. Qualitative review of tibial inter-condylar eminences suggested that these could be easily identifiable. When taking the medial angle from a medial–lateral reference line, the Akagi line showed a mean of 96.90° (± 10.27), inter-eminence line 94.52° (± 12.84), and Dalury line 88.06° (± 11.75). The angle produced by the Dalury line was significantly different from both the Akagi and inter-eminence lines (P ≤ 0.001). The Akagi line and inter-eminence line showed a strong correlation (r = 0.74). The Dalury line showed a weaker correlation with both the Akagi line (r = 0.69) and inter-eminence line (r = 0.40).ConclusionThis study suggested that tibial rotation lines showed excellent intra/inter-observer reliability and reproducibility. The novel and easily drawn inter-eminence line showed strong correlation with the Akagi line and could be used for tibial tray rotational alignment in total knee arthroplasty. |
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Keywords: | Alignment Rotation Tibia Total knee replacement |
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