Angelo Graceffa1, Pier Francesco Indelli2, Kaitlyn Basnett3, Massimiliano Marcucci4. 1. Orthopaedics Clinic, university of Catania, Italy. 2. Centro eccellenza Sostituzioni articolari toscana (CeSat), Orthopaedics Clinic, university of Florence, Italy -Fondazione Onlus "...In Cammino...", Fucecchio, Italy ; Breyer Center for Overseas Study, Stanford university in Florence, Italy ; Orthopaedics Clinic, university of Florence, Italy. 3. Breyer Center for Overseas Study, Stanford university in Florence, Italy. 4. Centro eccellenza Sostituzioni articolari toscana (CeSat), Orthopaedics Clinic, university of Florence, Italy -Fondazione Onlus "...In Cammino...", Fucecchio, Italy ; Orthopaedics Clinic, university of Florence, Italy.
Abstract
PURPOSE: this study was conducted to compare the quantity of intercondylar bone removed during femoral box osteotomy for implantation of three contemporary posterior stabilized (PS) total knee arthroplasty designs: Sigma PS (DePuy), Vanguard (Biomet) and Persona (Zimmer). METHODS: we compared the maximum volumetric bone resection required for the housing of the PS mechanism of these three designs. Bone removal by each PS box cutting jig was three-dimensionally measured. The differences between the three designs were analyzed by the Kruskal-Wallis test. The Mann-Whitney U-test was used for pairwise comparisons. The level of significance was set at p<0.05. RESULTS: for small-size implants, the average box osteotomy volume of Persona was significantly smaller than the Vanguard and Sigma PS volumes (p=0.003). The mean difference between Vanguard and Sigma PS (p=0.01) was also significant. For medium size implants, the mean difference between Persona and Sigma PS (p=0.008) and the mean difference between Vanguard and Sigma PS (p=0.01) were statistically significant. For large size implants, the mean difference between Vanguard and Sigma PS (p=0.01) and the mean difference between Sigma PS and Persona (p=0.008) were statistically significant. CONCLUSIONS: irrespective of implant size, the Persona cutting jig always resected significantly less bone than did Vanguard and Sigma PS. CLINICAL RELEVANCE: although this study does not establish any clinical relevance of removing more or less bone at primary TKA, its results suggest that if a PS design is indicated, it is preferable to select a model which resects less distal femoral bone.
PURPOSE: this study was conducted to compare the quantity of intercondylar bone removed during femoral box osteotomy for implantation of three contemporary posterior stabilized (PS) total knee arthroplasty designs: Sigma PS (DePuy), Vanguard (Biomet) and Persona (Zimmer). METHODS: we compared the maximum volumetric bone resection required for the housing of the PS mechanism of these three designs. Bone removal by each PS box cutting jig was three-dimensionally measured. The differences between the three designs were analyzed by the Kruskal-Wallis test. The Mann-Whitney U-test was used for pairwise comparisons. The level of significance was set at p<0.05. RESULTS: for small-size implants, the average box osteotomy volume of Persona was significantly smaller than the Vanguard and Sigma PS volumes (p=0.003). The mean difference between Vanguard and Sigma PS (p=0.01) was also significant. For medium size implants, the mean difference between Persona and Sigma PS (p=0.008) and the mean difference between Vanguard and Sigma PS (p=0.01) were statistically significant. For large size implants, the mean difference between Vanguard and Sigma PS (p=0.01) and the mean difference between Sigma PS and Persona (p=0.008) were statistically significant. CONCLUSIONS: irrespective of implant size, the Persona cutting jig always resected significantly less bone than did Vanguard and Sigma PS. CLINICAL RELEVANCE: although this study does not establish any clinical relevance of removing more or less bone at primary TKA, its results suggest that if a PS design is indicated, it is preferable to select a model which resects less distal femoral bone.
Entities:
Keywords:
bone resection; box osteotomy; cruciate substituting; posterior stabilized; total knee arthroplasty
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