Bony Landmarks and Rotational Alignment in Total Knee Arthroplasty for Chinese Osteoarthritic Knees With Varus or Valgus Deformities

The purpose of this study was to investigate the rotational mismatch of total knee arthroplasty when taking the medial one third of the tibial tuberosity as a rotational landmark in Chinese osteoarthritic knees. Computed tomographic images of 49 osteoarthritic knees (42 with varus and 7 with valgus deformities) and 10 healthy knees were analyzed. The angle (α) between the 2 baselines for the anteroposterior axis of the femoral and tibial components was measured. The mean value of α in healthy knees was +6.45°, which increased significantly to +11.53° in varus knees (P = .002) and +12.17° in valgus knees (P = .04). It showed that there is a tendency for the tibial component to be externally rotated when the medial one third of the tibial tuberosity is defined as a rotational landmark. This finding is particularly prominent in Chinese osteoarthritic knees with varus or valgus deformities.