The Offset of the Tibial Shaft from the Tibial Plateau in Chinese People

Tang, Qiheng; Zhou, Yixin; Yang, Dinghui; Xu, Hao; Liu, Qing

doi:10.2106/jbjs.i.00969

Cited by 41 publications

(43 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, Asian people generally have a varus knee alignment [8,20] and Asian patients with varus knee osteoarthritis (OA) have varying degrees of tibia vara [12,16,24]. This anatomic variance has made it difficult to achieve proper frontal alignment and proper component positioning in TKA because the TSA does not align with the TMA and passes through a point lateral to the center of the tibial eminence [12,14,20,24].…”

Section: Introductionmentioning

confidence: 99%

“…This anatomic variance has made it difficult to achieve proper frontal alignment and proper component positioning in TKA because the TSA does not align with the TMA and passes through a point lateral to the center of the tibial eminence [12,14,20,24]. Consequently, lateralization of the tibial component is required to accord its center with the TSA, and it often needs downsizing of the component to avoid lateral overhang by the prosthesis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tibia Vara Affects the Aspect Ratio of Tibial Resected Surface in Female Japanese Patients Undergoing TKA

Mori¹,

Akagi²,

Asada³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Tibia vara seen in Japanese patients reportedly influences the tibial component alignment when performing TKA. However, it is unclear whether tibia vara affects the component position and size selection. Questions/purposes We therefore determined (1) the amount of medial tibial bow, (2) whether the tibia vara influences the aspect ratio of the tibial resected surface in aligning the tibial component with the tibial shaft axis, and (3) whether currently available tibial components fit the shapes of resected proximal tibias in terms of aspect ratio. Methods We measured the tibia vara angle (TVA), proximal varus angle (PVA), and the mediolateral and middle AP dimensions of the resected surface using threedimensional preoperative planning software in 90 knees of 74 female patients with varus osteoarthritis. We determined the correlations of the aspect ratio with TVA or PVA and compared the aspect ratios to those of five prosthesis designs. Results The mean TVA and PVA were 0.6°and 2.0°, respectively. The aspect ratio negatively correlated with both TVA and PVA (r = À0.53 and À0.55, respectively). The mean aspect ratio of the resected surface was 1.48 but gradually decreased with increasing AP dimension, whereas four of the five prostheses had a constant aspect ratio. Conclusions The aspect ratio of resected tibial surface was inversely correlated to the degree of tibia vara, and currently available prosthesis designs do not fit well to the resected surface in terms of aspect ratio. Clinical Relevance The design of a tibial component with a smaller aspect ratio could be developed to obtain better bone coverage in Japanese patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tibia Vara Affects the Aspect Ratio of Tibial Resected Surface in Female Japanese Patients Undergoing TKA

Mori¹,

Akagi²,

Asada³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…In Japan, more than 50,000 patients underwent TKA in 2008, and this number will likely increase as the population ages. However, almost all prosthetic implants have been designed and manufactured to accommodate the knee anatomy of Western Caucasians, and there is some doubt about the application of these systems to Asians, as the femoral size of Asians differs from that of Caucasians [1-8]. Moreover, even if the smallest size from each Western prosthesis company is used, it may be too big for some Asian subjects.…”

Section: Introductionmentioning

confidence: 99%

Asian-Specific total knee system: 5-14 year follow-up study

Hosaka

Saito

Ishii

et al. 2011

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundKnee size and body size differ in Asians compared with Caucasians. Nevertheless, many total knee arthroplasty (TKA) prostheses used worldwide are made for Western Caucasian subjects. As a result, an Asian's knee might not fit these prostheses. We studied the Flexible Nichidai Knee (FNK) system, a new model of TKA for Asian patients. The purpose of this report is to investigate the outcomes of this prosthesis retrospectively.MethodsWe investigated 1055 primary TKAs in 595 patients who underwent FNK for osteoarthritis (OA) in Japan and were followed for > 5 years. The knee score and function score were used for clinical evaluation. We examined the range of motion (ROM) preoperatively and at final follow-up and radiographic assessments. In addition, postoperative complications were investigated. A survivorship analysis was also conducted using two endpoints: revision for any reason and aseptic failure.Results890 knees in 502 patients were available for study (follow-up rate of 96.0%). The mean follow-up term was 8.3 years (range, 5.0-14.1 years). The knee and function score significantly improved from 41.3 to 90.3 and from 39.1 to 76.2 points, respectively (p < 0.001). The mean ROM in FNK posterior cruciate retaining (CR) type and FNK posterior-stabilized (PS) type ameliorated significantly from 107.8° and 95.6° to 110.7° and 110.4°, respectively (p < 0.01). Ten knees underwent revision surgery (infection in 3 cases, instability in 2, loosening in 2, and non-union of femoral supracondylar fracture, severe pain, and recurrent hemarthrosis in 1 each). The survivorship rate was 99.4% (95% CI, 99.0-99.8) at 5 years (n = 952 patients at risk) and 96.2% (95% CI, 91.9-100) at 12.5 years (n = 49 patients at risk).ConclusionThe FNK prosthesis for Asians achieved excellent mid- to long-term survivorship and clinical results.

show abstract

“…Hicks et al observed a variability in the location of the tibial canal of 1-15 mm from any direction to the center of the tibial component [16]. Because of the variations in anatomy, the use of a straight stem is not always possible and can lead to a poor coverage of the proximal part of the tibia and overhang of the tibial tray, coronal or sagittal malalignment of the mechanical axis of the knee, and non-filling of the tibial canal [18][19][20]. Therefore, in order to achieve maximal coverage of the tibial plateau without overhang and a well-centered stem, a tibial component with an offset stem is often needed.…”

Section: Anatomical Mismatchmentioning

confidence: 99%

The role of offset stems in revision knee arthroplasty

Baldini¹,

Balato

Franceschini

2015

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Revision total knee arthroplasty (TKA) represents a technically challenging procedure. The use of an offset stem extension can help in addressing some of the difficulties that can be encountered during surgery and, in particular, anatomical mismatch, malalignment, and gap balancing. Different offset stem extensions are available and can be classified according to four parameters: modularity, location of the offset, direction, and size of the displacement. Offset stem extensions can assist with implant alignment on the metaphysis if there is an offset diaphysis, can avoid medial-lateral or anterior-posterior component overhang, can reduce the incidence of coronal or sagittal malalignment, and can help in balancing the flexion and extension spaces by effectively translating the components. The aim of this study is to give an overview of the currently available evidence regarding the use of offset stem extensions in revision TKA as well as some useful surgical tips.

show abstract

The Offset of the Tibial Shaft from the Tibial Plateau in Chinese People

Abstract: The use of an anterolaterally offset tibial keel or stem seems more suitable for Chinese patients undergoing primary or revision total knee arthroplasty.

Cited by 41 publications

References 14 publications

Tibia Vara Affects the Aspect Ratio of Tibial Resected Surface in Female Japanese Patients Undergoing TKA

Tibia Vara Affects the Aspect Ratio of Tibial Resected Surface in Female Japanese Patients Undergoing TKA

Asian-Specific total knee system: 5-14 year follow-up study

The role of offset stems in revision knee arthroplasty

Contact Info

Product

Resources

About