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Archives of Orthopaedic and Trauma Surgery

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01-11-2020 | Knee Arthroplasty

Correlation of tibial component size and rotation with outcomes after total knee arthroplasty

Authors: Antonio Klasan, Joshua G. Twiggs, Brett A. Fritsch, Brad P. Miles, Thomas J. Heyse, Michael Solomon, David A. Parker

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2020

Abstract

Introduction

Tibial component design and positioning contribute more to patient satisfaction than previously realized. A surgeon needs to decide on the size and rotation, bearing in mind that coverage should be as high as possible, whilst malrotation and overhang should be avoided. No study investigates the impact of each of these components on clinical outcomes in a single cohort.

Materials and methods

This is a retrospective analysis of 1-year postoperative outcomes measured with the Knee Injury and Osteoarthritis Outcome (KOOS) Score, as well as a previously validated rotational CT protocol. Coverage, rotation from Insall’s axis, and overhang of an asymmetric tibial baseplate were measured, and positive and negative correlations to clinical outcomes were calculated.

Results

A total of 499 knees were analyzed. Patient average age was 68.4 years. Rotation within 7° internal and 5° external from Insall’s axis was a “safe zone”. Mean coverage was 76%. A total of 429 knees (94%) had a coverage of at least 70% and 102 knees (22%) greater than 80%. Overhang was detected in 23% of the cohort. Increased coverage was correlated to increased KOOS score and overhang correlated with a decreased KOOS score (p = 0.008).

Conclusions

This study demonstrates the individual role of three aspects of tibial component implantation properties in postoperative pain and short-term functional outcomes. Upsizing to the point of overhang with rotational tolerance of 7° internal and 3° external to Insall’s axis demonstrates best patient reported outcomes. Overhang decreases the clinical outcome by the same margin as loss of 16% of coverage.

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Title: Correlation of tibial component size and rotation with outcomes after total knee arthroplasty
Authors: Antonio Klasan
Joshua G. Twiggs
Brett A. Fritsch
Brad P. Miles
Thomas J. Heyse
Michael Solomon
David A. Parker
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 11/2020
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03550-z

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Springer Medicine

Correlation of tibial component size and rotation with outcomes after total knee arthroplasty

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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