Abstract
Appropriate coronal alignment of the lower extremity is essential for the long-term success of total knee arthroplasty (TKA). Previously, we documented that the palpable dorsal pedal artery (DPA) is a reliable anatomical landmark of the ankle center, which is important for positioning of the extramedullary tibial guide. In this clinical study, we investigated the advantages and pitfalls of the DPA palpation technique in TKA, and the accuracy of tibial component positioning in the coronal plane. Fifty knees were evaluated using the DPA palpation technique (S group), in comparison with historical controls without DPA palpation (C group). Prior to skin incision, the DPA was carefully palpated and marked at the tibiotalar joint level (S point). During surgery, the extramedullary tibial guide was placed with the same rotation to the proximal tibia, and the distal end of the guide was set at the S point. There was no difference in the patients' background characteristics between the C and S groups. Postoperative anteroposterior X-ray examination showed that the accuracy of tibial component positioning within 2 degrees was 92% in the S group and 72% in the C group (p=0.02). It is concluded that the DPA palpation technique is simple and useful for preventing malpositioning of the tibial component.
