Aim: Bony and soft tissue landmarks have been used in the past to determine the center of the ankle to facilitate the tibial cut using an extramedullary guide in total knee arthroplasty. However literature reports are scanty in regards to the most ideal method available and its reproducibility in marking the center of the ankle intra-operatively.
Methods: We describe a method of using an electrocardiogram (ECG) lead in determining the center of the ankle, thus facilitating the alignment of the extramedullary guide for the tibia.
Results: Using this technique, in our study the mean lateral tibial component angle was 90.09(84.2°-94.3°). The number of knees in the range of 88°-92.4° were 120 out of 122 knees (98.40%).
Conclusion: The described method is reliable and cheap, with reproducibility in determining the tibial cut in total knee arthroplasty.
Keywords: Centre of ankle; ECG lead; Extramedullary guide; TKA.