The influence of tibial morphology on the design of an anatomical tibial baseplate for TKA.
Publisher DOI
PubMed ID
24503228
Abstract
BACKGROUND
Finding the right balance between tibial coverage and minimal implant overhang is an important factor in TKA. Another significant cause of failure is component malrotation.
METHODS
An average master shape of the proximal tibia at TKA resection level was calculated using fine slice computed tomographies of 117 cadaveric knees. To find out whether alternate implant contours would be necessary depending on the patient's body size, we established five subgroups to compare. CAD-Analysis was performed to simulate the overhang produced after ±4°/±7°/±10° rotation.
RESULTS
A master shape for the tibial resection cut (with a 5° posterior slope, 7 mm under lateral joint line) could be determined. Neither left vs. right knee joint, nor male vs. female nor the size subdivision appears to alter the calculated master shape significantly. The optimized shape allowing for ±4° of rotational freedom was found to be the best variant.
CONCLUSIONS
Valid methods have been obtained to design a two-dimensional average shape of the tibial plateau. The modifications described in this study might come in useful, when designing future implant designs.
CLINICAL RELEVANCE
An optimized fit at the tibial plateau and lower rates of component malrotation may result in better outcomes after TKA.
Finding the right balance between tibial coverage and minimal implant overhang is an important factor in TKA. Another significant cause of failure is component malrotation.
METHODS
An average master shape of the proximal tibia at TKA resection level was calculated using fine slice computed tomographies of 117 cadaveric knees. To find out whether alternate implant contours would be necessary depending on the patient's body size, we established five subgroups to compare. CAD-Analysis was performed to simulate the overhang produced after ±4°/±7°/±10° rotation.
RESULTS
A master shape for the tibial resection cut (with a 5° posterior slope, 7 mm under lateral joint line) could be determined. Neither left vs. right knee joint, nor male vs. female nor the size subdivision appears to alter the calculated master shape significantly. The optimized shape allowing for ±4° of rotational freedom was found to be the best variant.
CONCLUSIONS
Valid methods have been obtained to design a two-dimensional average shape of the tibial plateau. The modifications described in this study might come in useful, when designing future implant designs.
CLINICAL RELEVANCE
An optimized fit at the tibial plateau and lower rates of component malrotation may result in better outcomes after TKA.
Date Issued
2014-03
Publication Type
Article
Subject(s)
Subjects
Prosthesis design
•
Tibial component
•
Tibial plateau
•
Total knee arthroplasty (TKA)
Language(s)
en
Author(s)
Hartel, Maximilian J | |
Loosli, Yannick | |
Delfosse, Daniel | |
Diel, Peter | |
Thali, Michael | |
Ross, Steffen | |
Eggli, Stefan |
Additional Credits
Journal
The knee
Publisher
Elsevier
ISSN
0968-0160
Access(Rights)
restricted