Wider Femoral and Mediolaterally Narrower Tibial Components Are Required for Total Knee Arthroplasty in Turkish Patients

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2019 Mar 3

PMID 30824980

Citations 7

Authors

Abdulhamit Misir

Kadir Ilker Yildiz

Turan Bilge Kizkapan

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the knee morphologic parameters in the Turkish population, compare them with known data, and identify new morphologic parameters.

Methods: Magnetic resonance (MR) images of 1000 healthy subjects aged 18-50 years were included. One orthopedic surgeon and one experienced musculoskeletal radiologist reviewed MR images and measured 22 morphologic parameters. Sex and side differences were evaluated. Correlations between age and measurement parameters were assessed. The measured parameters were compared with known data. Femoral and tibial condylar height differences were identified.

Results: A strong correlation was found among regarding all measurement parameters (p = 0.000 and k > 0.985 for all measurements) by both observers. A significant difference between the female and male subjects regarding the measurement parameters (p = 0.000) was found, except for the tibial coronal slope, posterior condylar angle (PCA), medial and lateral tibial slopes (MTS and LTS), and medial plateau depth. No measurement parameter was significantly correlated with age (n.s.). The femur surface ratio in male and female subjects was 1.29 ± 1.04 and 1.28 ± 1.12, respectively (n.s.). The tibial plateau aspect ratio was 61.4 ± 1.09 in males and 59.8 ± 1.57 in females (p = 0.004). The mean medial and lateral femoral condylar cartilage and bone height differences were 3.3 ± 1.1 and 3.1 ± 0.9 mm, respectively. The mean medial and lateral tibial condylar cartilage and bone height differences were 2.3 ± 0.3 and 1.6 ± 0.1 mm, respectively.

Conclusion: Compared to current designs, wider femoral and mediolaterally narrower tibial components are needed to provide well-fitting prosthesis and improve functional outcomes, especially in women. The data on femoral and tibial condylar height differences will be useful for future research on component design. In the clinical practice, the components developed based on these findings will have a substantial effect on postoperative outcomes and patient satisfaction.

Level Of Evidence: II.

Citing Articles

Distal femur morphology and the suitability of standard guides for knee arthroplasty in the Turkish population.

Incesoy M, Gungoren N, Aliyev O, Elmali N, Tuncay I, Yildiz F Acta Orthop Traumatol Turc. 2024; 58(1):39-44.

PMID: 38525509 PMC: 11058999. DOI: 10.5152/j.aott.2024.21066.

Evaluation of the relationship of posterior tibial slope with gender and age in Turkish population with 3 different methods.

Kavak S, Kaya S BMC Musculoskelet Disord. 2024; 25(1):102.

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Investigation of Morphometric Factors Associated With Adolescent ACL Rupture.

Akcaalan S, Kavaklilar A, Caglar C, Ugurlu M, Dogan M, Akkaya M Orthop J Sports Med. 2023; 11(9):23259671231194928.

PMID: 37693804 PMC: 10492494. DOI: 10.1177/23259671231194928.

Do age, gender, and region affect tibial slope? A multi-center study.

Akcaalan S, Akkaya M, Dogan M, Valdivielso A, Zeiton M, Mohammad H Arch Orthop Trauma Surg. 2023; 143(12):6983-6991.

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Radiographic measurement of the posterior tibial slope in normal Chinese adults: a retrospective cohort study.

Chen Y, Ding J, Dai S, Yang J, Wang M, Tian T BMC Musculoskelet Disord. 2022; 23(1):386.

PMID: 35473639 PMC: 9040249. DOI: 10.1186/s12891-022-05319-4.

References

Griffin F, Math K, Scuderi G, Insall J, Poilvache P . Anatomy of the epicondyles of the distal femur: MRI analysis of normal knees. J Arthroplasty. 2000; 15(3):354-9. DOI: 10.1016/s0883-5403(00)90739-3. View

Hall F . Radiographic diagnosis and accuracy in knee joint effusions. Radiology. 1975; 115(1):49-54. DOI: 10.1148/115.1.49. View

Kellgren J, Lawrence J . Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957; 16(4):494-502. PMC: 1006995. DOI: 10.1136/ard.16.4.494. View

Hitt K, Shurman 2nd J, Greene K, McCarthy J, Moskal J, Hoeman T . Anthropometric measurements of the human knee: correlation to the sizing of current knee arthroplasty systems. J Bone Joint Surg Am. 2003; 85-A Suppl 4:115-22. View

Yip D, Zhu Y, Chiu K, Ng T . Distal rotational alignment of the Chinese femur and its relevance in total knee arthroplasty. J Arthroplasty. 2004; 19(5):613-9. DOI: 10.1016/j.arth.2003.11.008. View

Kwak D, Surendran S, Pengatteeri Y, Park S, Choi K, Gopinathan P . Morphometry of the proximal tibia to design the tibial component of total knee arthroplasty for the Korean population. Knee. 2007; 14(4):295-300. DOI: 10.1016/j.knee.2007.05.004. View

Hashemi J, Chandrashekar N, Gill B, Beynnon B, Slauterbeck J, Schutt Jr R . The geometry of the tibial plateau and its influence on the biomechanics of the tibiofemoral joint. J Bone Joint Surg Am. 2008; 90(12):2724-34. PMC: 2663332. DOI: 10.2106/JBJS.G.01358. View

Cheng F, Ji X, Lai Y, Feng J, Zheng W, Sun Y . Three dimensional morphometry of the knee to design the total knee arthroplasty for Chinese population. Knee. 2009; 16(5):341-7. DOI: 10.1016/j.knee.2008.12.019. View

Mahoney O, Kinsey T . Overhang of the femoral component in total knee arthroplasty: risk factors and clinical consequences. J Bone Joint Surg Am. 2010; 92(5):1115-21. DOI: 10.2106/JBJS.H.00434. View

10.

Dai Y, Scuderi G, Penninger C, Bischoff J, Rosenberg A . Increased shape and size offerings of femoral components improve fit during total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2014; 22(12):2931-40. PMC: 4237918. DOI: 10.1007/s00167-014-3163-6. View

11.

Li P, Tsai T, Li J, Zhang Y, Kwon Y, Rubash H . Morphological measurement of the knee: race and sex effects. Acta Orthop Belg. 2014; 80(2):260-8. View

12.

Kobayashi H, Akamatsu Y, Kumagai K, Kusayama Y, Aratake M, Saito T . Is the surgical epicondylar axis the center of rotation in the osteoarthritic knee?. J Arthroplasty. 2014; 30(3):479-83. DOI: 10.1016/j.arth.2014.10.024. View

13.

Han H, Oh S, Chang C, Kang S . Anthropometric difference of the knee on MRI according to gender and age groups. Surg Radiol Anat. 2015; 38(2):203-11. DOI: 10.1007/s00276-015-1536-2. View

14.

Wernecke G, Seeto B, Chen D, Macdessi S . Posterior condylar cartilage thickness and posterior condylar offset of the femur: a magnetic resonance imaging study. J Orthop Surg (Hong Kong). 2016; 24(1):12-5. DOI: 10.1177/230949901602400105. View

15.

Weinberg D, Williamson D, Gebhart J, Knapik D, Voos J . Differences in Medial and Lateral Posterior Tibial Slope: An Osteological Review of 1090 Tibiae Comparing Age, Sex, and Race. Am J Sports Med. 2016; 45(1):106-113. DOI: 10.1177/0363546516662449. View

16.

Freisinger G, Schmitt L, Wanamaker A, Siston R, Chaudhari A . Tibiofemoral Osteoarthritis and Varus-Valgus Laxity. J Knee Surg. 2016; 30(5):440-451. PMC: 5830133. DOI: 10.1055/s-0036-1592149. View

17.

Kim T, Phillips M, Bhandari M, Watson J, Malhotra R . What Differences in Morphologic Features of the Knee Exist Among Patients of Various Races? A Systematic Review. Clin Orthop Relat Res. 2016; 475(1):170-182. PMC: 5174057. DOI: 10.1007/s11999-016-5097-4. View

18.

Thilak J, George M . Patient - implant dimension mismatch in total knee arthroplasty: Is it worth worrying? An Indian scenario. Indian J Orthop. 2016; 50(5):512-517. PMC: 5017173. DOI: 10.4103/0019-5413.189618. View

19.

Wang Y, Yang T, Zeng C, Wei J, Xie D, Yang Y . Association Between Tibial Plateau Slopes and Anterior Cruciate Ligament Injury: A Meta-analysis. Arthroscopy. 2017; 33(6):1248-1259.e4. DOI: 10.1016/j.arthro.2017.01.015. View

20.

Kang K, Koh Y, Son J, Kwon O, Lee J, Kwon S . Influence of Increased Posterior Tibial Slope in Total Knee Arthroplasty on Knee Joint Biomechanics: A Computational Simulation Study. J Arthroplasty. 2017; 33(2):572-579. DOI: 10.1016/j.arth.2017.09.025. View