Use of tibialis anterior tendon as distal landmark for extramedullary tibial alignment in total knee arthroplasty: an anatomical study

Am J Orthop (Belle Mead NJ). 2009 Mar;38(3):E68-70.


We studied the accuracy of using the tibialis anterior tendon (TAT) as a distal landmark for extramedullary alignment in total knee arthroplasty. Forty-five consecutive ankle magnetic resonance imaging scans were reviewed. On the computerized images, a digital ruler was used to measure the distance from the midpoint of the distal tibia (point M) to the TAT. Mean distance was 1.89 mm; range was 0 to 4.5 mm (95% confidence interval, 1.45-2.33). For 7 (15.6%) of the 45 scans, the distance was 0 mm. On 38 scans (84.4%), the TAT was within 2 mm of point M. The TAT is an easily palpable fixed anatomical structure that corresponds very closely to the midpoint of the distal tibia.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ankle / anatomy & histology
  • Arthroplasty, Replacement, Knee / methods*
  • Child
  • Female
  • Humans
  • Intraoperative Care
  • Knee Joint / anatomy & histology*
  • Knee Joint / surgery
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Postoperative Complications / prevention & control
  • Reproducibility of Results
  • Tendons / anatomy & histology*
  • Tibia / anatomy & histology*
  • Young Adult