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Lapo De Luca - Ospedal civile Empoli - Florence, Italy*Email: drbaldiniandrea@yahoo.itThe anterior curve of the tibial plateau cortex represents a realiable and reproducible landmark which may help aligning the tibialcomponent with the femoral component and the extensor mechanismFew studies analyzed the tibial component rotational alignment during total knee arthroplasty. Malrotation can affect both patellofemoraland tibio-femoral postoperative function. We evaluated the rotational relationship between femur and tibia, and weinvestigated which tibial landmark consistently matches the rotation of the femoral epicondylar axis in full extension (Fig 1).Axial magnetic resonance images of 124 normal knees (statistical power 1-beta=0.8) were analyzed separately by three authors.Scanograms were obtained with the knee in full extension and with the long axis of the foot (second metatarsal bone) aligned on theneutral sagittal plane. The surgical epicondylar axis was drawn and projected over the proximal tibia and tibial tuberosity slices. Multipleanatomical tibial rotational landmarks were drawn and symmetric tibial component digital templates of different sizes were alignedaccording to each landmark. Alignment of the virtual tibial components was then compared to that of the projected femoral epicondylaraxis (Fig 2). The best antero-posterior line to achieve rotational matching between the components was drawn on the proximal tibiaslice of each patient.Results of rotation (positive = external rotation, negative = internal) relative to the epicondylar axis were (Fig 3): (a) Medial third-tothe middle third of the tibial tubercle 1.2°+/-5.7, (b) Akagi's line (centre of the posterior cruciate ligament tibial insertion to the mostmedial part of the tibial tubercle) -11.5+/-6.5, (c) The anterior curved tibial plateau cortex (curve-on-curve matching between thetibial template and the anterior cortex) 1.0+/-2.9. Intraclass correlation coefficient resulted 0.923, 0,881, and 0.949 for the Akagi'sline, Middle third of tibial tubercle, and the curve-on-curve reference respectively.The anterior curve of the tibial plateau cortex represents a realiable and reproducible landmark which may help aligning the tibialcomponent with the femoral component and the extensor mechanism (Fig 4, 5).FiguresFigure 1 Figure 2 Figure 3 Figure 4 Figure 5Thursday, October 7, 2010, 14:50-15:30Session A6: Hip MiscellaneousRevision Total Hip Arthroplasty in Massive Proximal Femoral Bone LossWith Tumor EndoprosthesisBackground:*Ayman Bassiony - Ain Shams University - Cairo, Egypt*Email: aymanbassiony@yahoo.comRevision THA presents significant challenges for the surgeon when the proximal femur isdeficient or mechanically unreliable. The aim of this study is to assess the clinical andfunctional results of the use of tumor enndoprosthesis to reconstruct the proximal femur whenthere is massive bone loss.Patients and Methods:A prospective study was conducted involving 10 cases. The follow up of the cases ranged from12 months to 30 months with a mean period of an average of 23months. The indications forfile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]