The human body is a marvel of symmetry and balance, but sometimes, due to various factors, this symmetry can be disrupted. This is particularly true in the case of the proximal tibial epiphysis, a part of the tibia, or shinbone, located near the knee. When this happens, it can lead to a range of issues, including pain, discomfort, and difficulty in movement. One of the ways to address this is through surgical intervention, which aims to restore the alignment of the tibial component. However, this process is not as straightforward as it might seem, as the recent study suggests.
The study focuses on the importance of correcting for asymmetry of the proximal tibial epiphysis when determining postoperative alignment deviations in kinematic alignment from planned alignment of the tibial component on the native tibia. In simpler terms, it means that when surgeons are planning and assessing the success of surgery to correct the alignment of the shinbone, they need to take into account any existing asymmetry in the bone structure.
This is crucial because, as the study points out, random differences due to asymmetry can be substantial. These differences can be so significant that they can affect the surgical outcome. If these asymmetries are not taken into account, the post-surgery alignment of the tibial component may not be as accurate as planned. This could potentially lead to less than optimal results from the surgery, including continued pain or discomfort, and possibly even the need for further surgical intervention.
The study further suggests that post-operative computer tomograms, which are essentially detailed cross-sectional images of the body, of the contralateral healthy tibia (the tibia on the opposite side of the body) should not be used to directly assess the accuracy of tibial component alignment on a group level without correcting for differences in tibial slope and varus-valgus orientation. The varus-valgus orientation refers to the inward or outward tilt of the bone, while the tibial slope refers to the angle of the top surface of the tibia.
In practical terms, this means that surgeons need to be aware of these potential asymmetries and take them into account when planning and assessing the success of surgery. This could involve using more sophisticated imaging techniques or software to accurately measure and correct for these asymmetries. It could also involve a more individualized approach to surgery, taking into account the unique bone structure of each patient.
In conclusion, this study highlights the importance of considering the asymmetry of the proximal tibial epiphysis in surgical planning and postoperative assessment. By doing so, surgeons can improve the accuracy of their surgical interventions, leading to better outcomes for their patients. This is a significant contribution to the field of podiatric surgery and pain management, and could potentially lead to improved techniques and practices in the future.
To read the full journal article, head to https://www.clinbiomech.com/article/S0268-0033(24)00047-0/fulltext?rss=yes