Michel P Bonnin1, Mo Saffarini2, David Shepherd3, Nadine Bossard4,5,6, Emmanuelle Dantony4,5,6. 1. Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008, Lyon, France. bonnin.michel@gmail.com. 2. Accelerate Innovation Management, 1 rue de la navigation, 1201, Geneva, Switzerland. 3. Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008, Lyon, France. 4. Service de Biostatistique, Hospices Civils de Lyon, 69424, Lyon, France. 5. Université Lyon I, 69622, Villeurbanne, France. 6. CNRS, UMR 5558, Laboratoire Biostatistique Santé, 69495, Pierre-Bénite, France.
Abstract
PURPOSE: The incidence of anteroposterior overhang of the tibial component after TKA and its effect on clinical outcome were investigated, and the morphometric characteristics of the knees in which tibial baseplates were oversized were identified. METHOD: One hundred and fourteen consecutive TKAs were retrospectively assessed. The dimensions of the tibia were measured on a pre-operative CT scan and were compared with those of the implanted tibial component. We analysed the effect of anteroposterior and mediolateral size variations on clinical outcomes 1 year after surgery. RESULTS: An anteroposterior overhang was observed in 87 % of cases on the lateral plateau, in 88 % on the central plateau and in 25 % on the medial tibial plateau. The mean post-pre-operative size differences were 3.2 ± 2.7, 2.8 ± 2.7 and -1.6 ± 2.3 mm, respectively. (Positive value means oversizing). A mediolateral overhang of the tibial component was found in 61 % of the patients. Oversizing was significantly greater and more frequent in females. Patients oversized in the anteroposterior dimension had lower post-operative pain scores. Patients with mediolateral oversizing had decreased flexion 1 year after surgery. Anteroposterior oversizing was observed more frequently in patients with asymmetric tibial plateaus, while mediolateral oversizing was observed more frequently in patients with small tibias. CONCLUSIONS: This study demonstrates that the incidence of oversized tibial plateau components is surprisingly high and that functional outcomes are lower in the case of mediolateral or anteroposterior oversizing. The risk of oversizing could be predicted as it occurs predominantly in patients with asymmetric proximal tibia and/or small tibia. LEVEL OF EVIDENCE: IV.
PURPOSE: The incidence of anteroposterior overhang of the tibial component after TKA and its effect on clinical outcome were investigated, and the morphometric characteristics of the knees in which tibial baseplates were oversized were identified. METHOD: One hundred and fourteen consecutive TKAs were retrospectively assessed. The dimensions of the tibia were measured on a pre-operative CT scan and were compared with those of the implanted tibial component. We analysed the effect of anteroposterior and mediolateral size variations on clinical outcomes 1 year after surgery. RESULTS: An anteroposterior overhang was observed in 87 % of cases on the lateral plateau, in 88 % on the central plateau and in 25 % on the medial tibial plateau. The mean post-pre-operative size differences were 3.2 ± 2.7, 2.8 ± 2.7 and -1.6 ± 2.3 mm, respectively. (Positive value means oversizing). A mediolateral overhang of the tibial component was found in 61 % of the patients. Oversizing was significantly greater and more frequent in females. Patients oversized in the anteroposterior dimension had lower post-operative pain scores. Patients with mediolateral oversizing had decreased flexion 1 year after surgery. Anteroposterior oversizing was observed more frequently in patients with asymmetric tibial plateaus, while mediolateral oversizing was observed more frequently in patients with small tibias. CONCLUSIONS: This study demonstrates that the incidence of oversized tibial plateau components is surprisingly high and that functional outcomes are lower in the case of mediolateral or anteroposterior oversizing. The risk of oversizing could be predicted as it occurs predominantly in patients with asymmetric proximal tibia and/or small tibia. LEVEL OF EVIDENCE: IV.
Entities:
Keywords:
Knee flexion; Oversizing; Pain; Tibial component; Total knee arthroplasty
Authors: P Ornetti; S Parratte; L Gossec; C Tavernier; J-N Argenson; E M Roos; F Guillemin; J F Maillefert Journal: Osteoarthritis Cartilage Date: 2007-10-01 Impact factor: 6.576
Authors: Michel Bonnin; J R Laurent; S Parratte; F Zadegan; R Badet; A Bissery Journal: Knee Surg Sports Traumatol Arthrosc Date: 2009-12-24 Impact factor: 4.342
Authors: Jelle P van der List; Harshvardhan Chawla; Leo Joskowicz; Andrew D Pearle Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-09-06 Impact factor: 4.342
Authors: Lucas Beckers; Jacobus H Müller; Jeremy Daxhelet; Salvatore Ratano; Mo Saffarini; Tarik Aït-Si-Selmi; Michel P Bonnin Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-06-01 Impact factor: 4.342
Authors: Arnd Steinbrück; Andreas Fottner; Christian Schröder; Matthias Woiczinski; Markus Schmitt-Sody; Tatjana Müller; Peter E Müller; Volkmar Jansson Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-11-03 Impact factor: 4.342
Authors: Lucas Beckers; Jacobus H Müller; Jeremy Daxhelet; Mo Saffarini; Tarik Aït-Si-Selmi; Michel P Bonnin Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-01-29 Impact factor: 4.342
Authors: Sanar S Yokhana; D Alex Hamilton; Sasha A Stine; Lauren N Stimson; Abdul K Zalikha; Chaoyang Chen; Hussein F Darwiche Journal: J Orthop Date: 2021-02-09