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- Title
Underhang of the tibial component increases tibial bone resorption after total knee arthroplasty.
- Authors
Gu, ShiZhong; Kuriyama, Shinichi; Nakamura, Shinichiro; Nishitani, Kohei; Ito, Hiromu; Matsuda, Shuichi
- Abstract
<bold>Purpose: </bold>One of the causes of aseptic loosening is marked tibial bone resorption (TR) at the tibial bone-component interface after total knee arthroplasty (TKA). It was hypothesized that insufficient coverage of the tibial component and improper cementing technique would cause increased TR after cemented TKA.<bold>Methods: </bold>One hundred thirty-four primary TKAs in 107 patients with varus osteoarthritis were included in this study. The relationships between the TRs at 2 years after TKA and the tibial component underhang (TUH), the thickness of the cement mantle around the keel, and clinical parameters were evaluated.<bold>Results: </bold>The widths of TRs on anteroposterior radiographs were significantly larger on the medial side than on the lateral side (p = 0.001), whereas the difference between the anterior and posterior sides on lateral radiographs was relatively small. Multiple regression analyses showed that medial TR was positively related to medial TUH (p = 0.006), and lateral TR was positively related to a thicker distal cement mantle (p = 0.027). On the lateral view, stepwise selection indicated that postoperative knee flexion angle was the most significant risk factor (p = 0.005) for anterior TR, and posterior TUH was the strongest predictor (p = 0.001) of posterior TR.<bold>Conclusions: </bold>To avert postoperative progressive TR, surgeons should perfectly fit a suitably sized tibial component to the medial edge of the tibia. Also, care should be taken to avoid an excessive cement mantle at the distal portion of the keel during TKA.<bold>Level Of Evidence: </bold>IV.
- Subjects
BONE resorption; TOTAL knee replacement; ARTHROPLASTY; RADIOGRAPHS; REGRESSION analysis; KNEE surgery; OSTEOARTHRITIS diagnosis; TIBIA surgery; ARTIFICIAL joints; BONE cements; RANGE of motion of joints; KNEE; KNEE diseases; OSTEOARTHRITIS; RADIOGRAPHY; TIBIA
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2019, Vol 27, Issue 4, p1270
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-018-5309-4