The precision and accuracy of templating the size of unicondylar knee arthroplasty

Kasis, Ata; Pacheco, Reinaldo Tadeu Boscolo; Hekal, Waleed; Farhan, M.J.; Smith, David; Ali, Ahmad M.

doi:10.1016/j.knee.2004.06.003

Cited by 14 publications

(8 citation statements)

References 5 publications

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“…(Intra-observer variability, FTA = 0.87, TPA = 0.83, PTS = 0.80). Moreover, since limb alignment and survivorship in a UKA are very sensitive to change in JL [39][40][41]; a previously validated method, based on the correlation between femoral width and the distance from the femoral adductor tubercle to JL, was used for radiographic JL measurement [42]. Briefly, the JL was assessed by calculating the distance from the adductor tubercle according to the femoral width multiplied by a validated ratio [43].…”

Section: Issn: 2334-2846mentioning

confidence: 99%

Early Failure in Medial Unicondylar Arthroplasty: Radiographic Analysis on the Importance of Joint Line Restoration

et al. 2018

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Survivorship of unicondylar knee arthroplasty (UKA) remains a drawback, especially compared with the outcome of total knee arthroplasty. This could be improved by identifying and correcting failure mechanisms. To this purpose, this study aimed at exploring failure modalities of UKA, with particular focus on the role of joint line (JL) position and alignment as variable to be optimized for a successful outcome. This study explored modes of failure in 266 medial UKAs. Radiological comparison was performed between 24 failures and 24 matched controls, to determine the importance of UKA positioning in terms of femorotibial angle (FTA), tibial plateau angle, and posterior tibial slope (PTS). Radiographic comparative analysis showed statistically significant differences in the failure group compared with the control group in terms of variation in FTA ( = 0.0222), PTS ( = 0.0025), and JL height ( = 0.0022). Variations not only in FTA but also PTS and JL height were correlated with failures observed in this series. Thus, based on the results of this study, it emerges that JL position should be carefully controlled in all planes while implanting a UKA. This is a Level III, case-control study.

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Section: Issn: 2334-2846mentioning

confidence: 99%

Early Failure in Medial Unicondylar Arthroplasty: Radiographic Analysis on the Importance of Joint Line Restoration

et al. 2018

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“…Bothra et al have showed that pre-operating templating has only slight to moderate interobserver and intra-observer reliability in determining the ideal femoral size [17]. Similarly, Kasis et al have shown poor inter-observer reliability of templating [18]. Hence, the accuracy of the pre-operative templating to determine the size of the femoral component is questionable and it is not routinely recommended [9].…”

Section: Introductionmentioning

confidence: 99%

Femoral Component Sizing in Oxford Unicompartmental Knee Replacement: Existing Guidelines Do Not Work for Indian Patients

et al. 2018

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Oxford unicompartmental knee replacement (OUKR) has shown excellent long-term clinical outcomes as well as implant survival when used for correct indications with optimal surgical technique. Anteromedial osteoarthritis is highly prevalent in Indian patients, and OUKR is the ideal treatment option in such cases. Uncertainty prevails about the best method to determine femoral component size in OUKR. Preoperative templating has been shown to be inaccurate, while height- and gender-based guidelines based on European population might not apply to the Indian patients. Microplasty instrumentation introduced in 2012 introduced the sizing spoon, which has the dual function of femoral component sizing and determining the level of tibia cut. We aimed to check the accuracy of sizing spoon and also to determine whether the present guidelines are appropriate for use in the Indian patients. A total of 130 consecutive Oxford mobile bearing medial cemented UKR performed using the Microplasty instrumentation were included. The ideal femoral component size for each knee was recorded by looking for overhang and underhang in post-operative lateral knee radiograph. The accuracy of previous guidelines was determined by applying them to our study population. Previously published guidelines (which were based on Western population) proved to be accurate in only 37% of cases. Hence, based on the demographics of our study population, we formulated modified height- and gender-based guidelines, which would better suit the Indian population. Accuracy of modified guidelines was estimated to be 74%. The overall accuracy of sizing spoon (75%), when used as an intraoperative guide, was similar to that of modified guidelines. Existing guidelines for femoral component sizing do not work in Indian patients. Modified guidelines and use of intraoperative spoon should be used to choose the optimal implant size while performing OUKR in Indian patients.

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“…Two studies of templating unicondylar knee arthroplasty reported poor accuracy and significant intraobserver and interobserver variation in predicting the size of the components. 8,18 Several studies have questioned the role of templating for primary total knee arthroplasty (TKA) component size. 2,3,13,15,31 These studies were limited by their retrospective nature, small number of knees, wide variety of implant designs, and inconsistent methodology.…”

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confidence: 99%

Value of Preoperative Templating for Primary Total Knee Arthroplasty

Gaizo¹,

Soileau²,

Lachiewicz³

2009

J Knee Surg

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The precision and accuracy of templating the size of unicondylar knee arthroplasty

Cited by 14 publications

References 5 publications

Early Failure in Medial Unicondylar Arthroplasty: Radiographic Analysis on the Importance of Joint Line Restoration

Early Failure in Medial Unicondylar Arthroplasty: Radiographic Analysis on the Importance of Joint Line Restoration

Femoral Component Sizing in Oxford Unicompartmental Knee Replacement: Existing Guidelines Do Not Work for Indian Patients

Value of Preoperative Templating for Primary Total Knee Arthroplasty

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