The effect of tibial component sizing on patient reported outcome measures following uncemented total knee replacement

Abram, Simon G F; Marsh, A.G.; Brydone, A S; Nicol, Fiona; Aslam, M.; Spencer, S.J.

doi:10.1016/j.knee.2014.05.010

Cited by 29 publications

(23 citation statements)

References 11 publications

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“…In this study, the incidence rates of severe overhang and underhang (>3 mm) were decreased with the Persona® knee system as compared with NexGen LPS-Flex®, which could be important in improving clinical outcomes. However, several studies reported that clinical outcomes related to size mismatch are different at least 3-years after surgery [15,28,29,37]. In the present study, only the incidence rates of overhang and underhang were con rmed.…”

Section: Discussioncontrasting

confidence: 46%

“…By contrast, minor underhang was de ned as 1 to 3 mm, and major underhang was de ned as smaller by > 3 mm. Measurements within 1 mm of overhang or underhang were considered to indicate proper coverage [18,29]. The degrees of overhang and underhang were compared with those in a previous cases study that used the NexGen-LPS-Flex® system (Zimmer Biomet, Warsaw, Indiana) [30].…”

Section: ) Surgical Treatment and Postoperative Managementmentioning

confidence: 99%

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Early Clinical and Radiological outcomes of the New Anatomic Knee System : Minimum 3-year Follow-up.

Ryu

Jeon

Shin³

et al. 2020

Preprint

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Background: For total knee arthroplasty (TKA), implant design and proper coverage are important for achieving patient satisfaction. An asymmetrical anatomic implant (Persona® knee system, Zimmer Biomet, Warsaw, Indiana) enables accurate coverage and minimal bone cutting. This study aimed to analyze the clinical and radiological outcomes of TKA using an asymmetrical anatomic implant over a minimum 3-year follow-up.Methods: The medical records of 94 patients who underwent 132 TKAs using the Persona® knee system, between April 2015 and January 2016 were reviewed. Pre- and post-operative clinical outcomes (assessed using the International Knee Documentation Committee (IKDC), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores, and range of motion (ROM) were reviewed. The mechanical hip-knee-ankle (HKA) axis, component overhang and underhang and presence of a radiolucent line (RLL) were evaluated. Liner thickness were also reviewed.Results: At 3-year follow-up, the mean ROM improved from 108.4° to 130.3°. The mean IKDC subjective, WOMAC and global KOOS score significantly improved from 29.2 to 70.3, from 64.2 to 11.5, and from 66.6 to 21.7, respectively (p<0.0001). The mean mechanical HKA axis indicated the correction of the malalignment (from 9.2° varus to 0.3° varus, p<0.001). The incidence rates of >3-mm bone-to-implant size mismatch were 6.8% and 8.3% for the femoral and tibial components, respectively. RLL was found in seven cases, but they were small (>2 mm) and did not progress. In 36.3% of the knees, the additional liner thickness (11 or 13mm) was used. No case of implant loosening or early failure related to the implant design occurred. Conclusion: TKA using the Persona® knee system improved all the clinical knee scores and ROM without signs of early failure. This knee system also provides more implant size options than the conventional TKA systems and facilitates ligament balancing.

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Section: Discussioncontrasting

confidence: 46%

Section: ) Surgical Treatment and Postoperative Managementmentioning

confidence: 99%

Early Clinical and Radiological outcomes of the New Anatomic Knee System : Minimum 3-year Follow-up.

Ryu

Jeon

Shin³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…33,38,47 However, there is a general agreement that correct sizing and capping of the tibial cortex is associated with more predictable fixation and less baseplate migration. 51,58,64 The current literature does not provide sufficient information to compare design concepts such as rotating platforms, fixed bearings and cruciate-retention or substitution. Further study is needed to evaluate these comparisons.…”

Section: Cementless Tkamentioning

confidence: 99%

Cementless total knee arthroplasty

Dalury

2016

The Bone & Joint Journal

121

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As the number of younger and more active patients treated with total knee arthroplasty (TKA) continues to increase, consideration of better fixation as a means of improving implant longevity is required. Cemented TKA remains the reference standard with the largest body of evidence and the longest follow-up to support its use. However, cementless TKA, may offer the opportunity of a more bone-sparing procedure with long lasting biological fixation to the bone. We undertook a review of the literature examining advances of cementless TKA and the reported results. Cite this article: Bone Joint J 2016;98-B:867-73.

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“…Conversely, if the component is bigger than the cortical border of the tibial plateau, it can cause chronic pain or limited range of motion (ROM) due to an overhang. 1,2 Moreover, the posterior tibial slope, another parameter that was shown to affect TKA survivorship, is generally recommended to be 0 to 7 degrees. 3 Overhang may be encountered during tibial component implantation, even on bony surfaces that were cut correctly may lead to lower postoperative patient satisfaction, and decreased clinical scores.…”

mentioning

confidence: 99%

Low-Degree Tibial Slope Angle Prevents Component Overhang by Enlarging the Lateral Plateau Surface Area in Total Knee Arthroplasty

et al. 2020

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This study aimed to investigate whether overhang or underhang around the tibial component that occurs during the placement of tibial baseplates was affected by different slope angles of the tibial plateau and determine the changes in the lateral and medial plateau diameters while changing the slope angle in total knee arthroplasty. Three-dimensional tibia models were reconstructed using the computed tomography scans of 120 tibial dry bones. Tibial plateau slope cuts were performed with 9, 7, 5, 3, and 0 degrees of slope angles 2-mm below the subchondral bone in the deepest point of the medial plateau. Total, lateral, and medial tibial plateau areas and overhang/underhang rates were measured at each cut level. Digital implantations of the asymmetric and symmetric tibial baseplates were made on the tibial plateau with each slope angles. Following the implantations, the slope angle that prevents overhang or underhang at the bone border and the slope angle that has more surface area was identified. A significant increase was noted in the total tibial surface area, lateral plateau surface area, and lateral anteroposterior distance, whereas the slope cut angles were changed from 9 to 0 degrees in both gender groups. It was found that the amount of posteromedial underhang and posterolateral overhang increased in both the asymmetric and symmetric tibial baseplates when the slope angle was changed from 0 to 9 degrees. Although the mediolateral diameter did not change after the proximal tibia cuts at different slope angles, the surface area and anteroposterior diameter of the lateral plateau could change, leading to increased lateral plateau area. Although prosthesis designs are highly compatible with the tibial surface area, it should be noted that the component overhangs, especially beyond the posterolateral edge, it can be prevented by changing the slope cut angle in males and females.

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The effect of tibial component sizing on patient reported outcome measures following uncemented total knee replacement

Cited by 29 publications

References 11 publications

Early Clinical and Radiological outcomes of the New Anatomic Knee System : Minimum 3-year Follow-up.

Early Clinical and Radiological outcomes of the New Anatomic Knee System : Minimum 3-year Follow-up.

Cementless total knee arthroplasty

Low-Degree Tibial Slope Angle Prevents Component Overhang by Enlarging the Lateral Plateau Surface Area in Total Knee Arthroplasty

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The effect of tibial component sizing on patient reported outcome measures following uncemented total knee replacement

Cited by 29 publications

References 11 publications

Early Clinical and Radiological outcomes of&nbsp;the New Anatomic Knee System : Minimum 3-year Follow-up.

Early Clinical and Radiological outcomes of&nbsp;the New Anatomic Knee System : Minimum 3-year Follow-up.

Cementless total knee arthroplasty

Low-Degree Tibial Slope Angle Prevents Component Overhang by Enlarging the Lateral Plateau Surface Area in Total Knee Arthroplasty

Contact Info

Product

Resources

About

Early Clinical and Radiological outcomes of the New Anatomic Knee System : Minimum 3-year Follow-up.

Early Clinical and Radiological outcomes of the New Anatomic Knee System : Minimum 3-year Follow-up.