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Asep Santoso
Department of Orthopaedic and Traumatology, Sebelas Maret University, Prof.Dr.R.Soeharso Orthopaedic Hospital, Surakarta.

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DISTANCE BETWEEN TIP OF FIBULAR HEAD TO TIBIAL TUBEROSITY: THE ALTERNATIVE BONY LANDMARK TO DEFINE MAXIMUM PROXIMAL TIBIAL CUT AND JOINT LINE LEVEL DURING TOTAL KNEE REPLACEMENT (TKR) Iwan Budiawan Anwar; Asep Santoso; Zarkasi Arimuqti; Wan Adi Surya
Biomedika Vol 13, No 2 (2021): Biomedika Agustus 2021
Publisher : Universitas Muhamadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v13i2.11807

Abstract

ABSTRAKProsedur penggantian sendi lutut telah banyak dilakukan untuk merawat pasien dengan kelainan anatomi yang berat disertai keterbaasan fungsi lutut. Saat melaksanakan reseksi tibia proksimal, ahli bedah harus menghindari pemotongan tulang yang tidak perlu. Oleh karena itu batasan reseksi pada tibia proksimal perlu dipastikan untuk mengembalikan garis sendi dan tidak melewati tepi atas fibula untuk menghindari lesi saraf perineal. Tujuan dari penelitian ini untuk mempelajari jarak rata-rata antara tuberositas tibia dan tepi atas fibula. Jarak tersebut dapat digunakan sebagai pedoman kasar bagi ahli bedah untuk menentukan tingkat maksimum pemotongan tibialis proksimal dari garis sendi. Penelitian ini mengukur jarak antara tepi atas fibula ke tuberositas tibia dari foto polos lateral lutut. Pengukuran dilakukan terhadap radiografi lateral lutut semua pasien yang menjalani operasi artroplasti lutut total di RS X Surakarta periode Januari 2018 - Januari 2019. Pengukuran menggunakan software Horos. Penelitian ini menggunakan 200 sampel, 151 wanita dan 49 pria. Jarak rata-rata keseluruhan antara ujung kepala fibula dan tuberositas tibia adalah 18,57 mm;  19,37 mm pada wanita dan18,31 mm pada pria. Tidak ada perbedaan yang signifikan antara pasien pria dan wanita. Kami merekomendasikan jarak 18,57 mm dari tuberositas tibia sebagai batas reseksi maksimum pada pemotongan tibialis proksimal selama TKR. Jarak ini juga dapat digunakan sebagai pedoman kasar untuk menentukan tingkat garis sendi dengan menambahkan 10 mm pada jarak tersebut. Kata kunci: Tuberositas Tibia, Reseksi Tibia, Batas Garis Sendi, Penggantian Sendi Lutut Total ABSTRACTTotal knee replacement (TKR) procedure has been widely performed to treat patients with severe deformity and limited knee function. During resection of the proximal tibia, the surgeon has to avoid unnecessary bone loss. Therefore the resection limitation on the proximal tibia needs to be confirmed to restore the native joint line and not to more distal than the tip of the fibular head to avoid peroneal nerve lesion. The purpose of this work is to study the average distance between the tuberosity of the tibia and the tip of the head of the fibula. The distance can be used as a rough guide for the surgeon to define the maximum level of proximal tibial cut and the level of the native joint line. This study measures the distance between the tip of the fibula head to the tibial tuberosity from the lateral plain radiograph of the knee. The measurement was performed to the lateral radiograph of the knee of all patients (200 knees) who received total knee arthroplasty surgery at X Hospital, Surakarta from January 2018 – January 2019. Horos software was used for measurement. There were 200 samples, 151 female and 49 male patients. The overall average distance between the tip of the fibular head and tibial tuberosity is 18,57 mm; 19,37 mm in female and 18.31 mmin male. There was no significant difference between male and female patients. We recommend the distance of 18,57 mm from tibial tuberosity as the maximum resection limit in proximal tibial cutting during TKR. This distance also could be used as a rough guide to defining a level of the joint line by adding 10 mm to it.  Keywords: Tibial Tuberosity, Tibial Resection, Joint Line Level, Total Knee Replacement