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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2019

01-04-2019 | KNEE

Underhang of the tibial component increases tibial bone resorption after total knee arthroplasty

Authors: ShiZhong Gu, Shinichi Kuriyama, Shinichiro Nakamura, Kohei Nishitani, Hiromu Ito, Shuichi Matsuda

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2019

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Level of evidence

IV.
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Metadata
Title
Underhang of the tibial component increases tibial bone resorption after total knee arthroplasty
Authors
ShiZhong Gu
Shinichi Kuriyama
Shinichiro Nakamura
Kohei Nishitani
Hiromu Ito
Shuichi Matsuda
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-5309-4

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