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Long term survivorship in Total Knee Arthroplasty is significantly dependent on prosthesis alignment.Accuracy of component positioning relies on alignment guides for making precise and accurate bone cuts.Hypotheses:   The aim of this study was to determine, compare and analyse the coronal alignment of the tibial component of a single implant system using 3 different techniques.Methods:   Retrospective study of cases from a prospectively collected database. Radiological assessment included measurement of the coronal alignment of tibial components of total knee arthroplasties, and its deviation from the mechanical axis. A comparison study of intramedullary, extramedullary and tibial crest alignment methods was performed.Results:   66 consecutive patients (3 groups of 22 each). Mean BMI was 26. The mean angle of deviation from the mechanical axis was significantly lesser (p&lt; 0.05) in the Tibial crest alignment group patients compared to the other 2 groups. Moreover, the number of outliers (+/-3 degrees) were 2 and 4 in the intra and extramedullary group, whereas there were none in the tibial crest group. The inter and intraclass correlation coefficient was 0.8 and 0.9 respectively.Conclusion:   The Tibial Crest Alignment Technique is an effective technique to produce consistent results to achieve optimal coronal alignment of the tibial component in TKA, even in patients with high BMI.

Tibial crest alignment technique-an effective technique to improve coronal alignment of tibial component in tka for arthritic knees