Bone & Joint Research Vol. 2, No. 1

Can tibial coverage in total knee replacement be reliably evaluated with three-dimensional image-based digital templating?

A. J. Costa, S. Lustig, C. J. Scholes, J-C. Balestro, M. Fatima, D. A. Parker


There remains a lack of data on the reliability of methods to estimate tibial coverage achieved during total knee replacement. In order to address this gap, the intra- and interobserver reliability of a three-dimensional (3D) digital templating method was assessed with one symmetric and one asymmetric prosthesis design.


A total of 120 template procedures were performed according to specific rotational and over-hang criteria by three observers at time zero and again two weeks later. Total and sub-region coverage were calculated and the reliability of the templating and measurement method was evaluated.


Excellent intra- and interobserver reliability was observed for total coverage, when minimal component overhang (intraclass correlation coefficient (ICC) = 0.87) or no component overhang (ICC = 0.92) was permitted, regardless of rotational restrictions.


Measurement of tibial coverage can be reliable using the templating method described even if the rotational axis selected still has a minor influence.

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