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Tibial Morphology for Proper Adjustment of Metal Augmentation in Revision Total Knee Arthroplasty

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Tibial Morphology for Proper Adjustment of Metal Augmentation in Revision Total Knee Arthroplasty

Yushi Sakamoto, MD, JAPAN Shinichiro Nakamura, MD, PhD, JAPAN Yugo Morita, MD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Young Dong Song, MD, PhD, UNITED STATES Yusuke Yamawaki, MD, JAPAN Shuichi Matsuda, MD, PhD, JAPAN

Kyoto University, Kyoto, Kyoto, JAPAN

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Knee

Anatomic Structure

Bones

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Arthroplasty

Summary: The design of current metal augmentation differs from the morphology of the proximal tibia, which has a greater tapering angle on the medial, lateral, and posterior surfaces.

Background

Metal augmentation is a remarkable option for the treatment of tibial bone defects. However, it is not well known whether the angle of currently available blocks matches the actual shape of the proximal tibia. The aim of this study was to analyze the bony contour of the proximal tibia and measure the angle of the taper for each resection surface to examine whether the angle of currently available metal augmentation blocks matches the actual tibia. It was hypothesized that the angle of currently available metal augmentation blocks did not match the morphology of the actual tibia and that the angle of the taper could be adjusted on the basis of the thickness and the side of the metal augmentation.

Materials And Methods

Computed tomography of the lower extremity was performed on consecutive 100 knees, and three-dimensional images of the tibia were reconstructed. The primary resection level was determined on the basis of a plane 10 mm below the center of the lateral tibial plateau without a posterior slope and perpendicular to the mechanical axis of the tibia. The assumed levels were set to 5, 10, 15, and 20 mm below the primary resection level. The tapering angle was calculated on the basis of the reduction value from the primary level to each resection surface at eight areas and compared with the angle of currently available metal augmentation. The tapering angles of metal augmentation were obtained from the company for three commonly used implants. The tapering angles of the proximal tibial bony morphology were compared with the angle of currently available metal augmentation: NexGen LPS-Flex, Vanguard 360, and Persona (Zimmer-Biomet, Warsaw, IN, USA).

Results

The tapering angle on the medial and lateral sides increased with the more distal resection level, which was up to 30° at the 20-mm level. The tapering angle on the posterior side also increased with the more distal resection level, which was approximately 40° at the 20-mm level. In most of the tibial bony surface, different contour was observed between medial and lateral compartments. The tapering angles of the conventional implants (NexGen and Vanguard 360) were considerably smaller than the tibial bone surface. In Persona, the tapering angle was greater than the conventional implants. However, the tapering angle was still smaller than that of the original tibial morphology.

Conclusions

The design of current metal augmentation differs from the morphology of the proximal tibia, which has a greater tapering angle on the medial, lateral, and posterior surfaces. Surgeons should pay attention to the size mismatch between the femoral and tibial components during revision TKA because the size of the tibial component fitted to the more distal level due to bone defects can be smaller with the current metal augmentation. Asymmetric metal augmentation with a greater tapering angle is required to fit the surface during distal bone resection.

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Subtalar Joint Compensation using Full-length Standing Lower Extremity Anteroposterior Radiograph after Total Knee Arthroplasty for Varus Osteoarthritis in Nara Medical University Hospital with 2-year Follow-up ePoster Presentation Jerre Co De Guzman, MD, PHILIPPINES Munehiro Ogawa, MD, PhD, JAPAN Yusuke Ozaki, MD, JAPAN Yasuhito Tanaka, Prof., JAPAN Yuki Nishimura, MD, JAPAN Maria Elizabeth Mercado, MD, MAS, PHILIPPINES
Total Knee Arthroplasty Outcomes Following Anterior Cruciate Ligament Reconstruction ePoster Presentation Brian Rao, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Eric Milliron, BS, UNITED STATES Parker Cavendish, BS, UNITED STATES James C. Kirven, BS, UNITED STATES Spencer E. Talentino, MD, UNITED STATES Charles Qin, MD, UNITED STATES Ryan H. Barnes, MD, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES
Treatment of Periprosthetic Infection after Total Knee Arthroplasty using an Ultrastatic Spacer ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Suzanne Kent, MD, UNITED STATES Ruijia Niu, MPH, UNITED STATES Ayesha Abdeen, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES
Golfers Have Greater Preoperative and Equal Postoperative Function When Undergoing Total Knee Arthroplasty Compared to Non-Golfers ePoster Presentation Patrick G Robinson, MBChB, MRCS, MS, MBA, UNITED KINGDOM Robert Kay, MBChB, UNITED KINGDOM Deborah Macdonald, BA(Hons), UNITED KINGDOM Andrew Murray, MBChB, FFSEM, UNITED KINGDOM Nick David Clement, MBBS, MD, PhD, FRCS(Orth), UNITED KINGDOM
Does Robotic Assisted Unicompartmental Knee Arthroplasty Restore Native Jointline More Accurately Than With Conventional Instruments? ePoster Presentation Ashok Kumar Podhili Subramani, MS, INDIA Shantanu S. Patil, MBBS, MS(Orth), INDIA SAWAN PAWAR, MBBS MS (ORTH), INDIA Kalaivanan Kanniyan, MBBS MS Orth, INDIA karthik jayachandran, MS, INDIA PICHAI SURYANARAYAN, MBBS MS ORTH, INDIA
Follow-Up after Primary Total Knee Arthroplasty with the Sigma PFC implant (DePuy Synthes Inc.) in Patients with Metal Allergy or Hypersensitivity ePoster Presentation Natalie Mengis, MD, SWITZERLAND Jules-Nikolaus Rippke, Dr. med. (MD), SWITZERLAND Sebastian Schmidt, GERMANY Tudor Daniel Cucos, MD, GERMANY Luis Alfredo Navas Contreras, MD, GERMANY Daniel Krahl, MD, GERMANY Marcus Streit, Prof., GERMANY
Lateral Unicompartmental Knee Arthroplasty (UKA) Showed a Lower Risk of Failure Compared to Medial Unicompartmental Knee Arthroplasty in the Register of Prosthetic Orthopedic Implants (RIPO) ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Domenico Alesi, MD, ITALY Barbara Bordini, Stat, ITALY Stefano Fratini, MD, ITALY Cristina Ancarani, Stat, ITALY Piero Agostinone, MD, ITALY Alberto Grassi, PhD, ITALY Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY
Short Term Outcome of Tibial Defect Reconstruction In Primary Total Knee Arthroplasty: A Retrospective Study ePoster Presentation Sanjib Kumar Behera, MS (Orth), DNB (Rehab), DPMR, INDIA Madhumita Pradhan, BDS, MPH, MHA , INDIA Vikram Choudhary, MD, UNITED STATES
Impact of Femur Correction on the Mechanical Alignment of the Total Knee Prosthesis ePoster Presentation Israel Alejandro Alejandro González Rizo, MD, MEXICO Fidel G Dobarganes, Prof, MEXICO Jorge Negrete Corona, MD, MEXICO Alberto Guevara-Alvarez, MD, MEXICO Franco Garcini Munguia, MD, MEXICO
Large Reduction In Postoperative Posterior Tibial Slope Risks Anterior Collapse Of The Tibial Component In Fixed-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Kazuhisa Hatayama, MD, PhD, JAPAN Masanori Terauchi, MD, JAPAN Shingo Kurihara, MD, JAPAN Satoshi Nonaka, MD, JAPAN Hibiki Kakiage, MD, JAPAN
Long-Term Results of Per-Operative Knee Arthroscopy in Confirming Suitability for Unicompartmental Arthroplasty ePoster Presentation James Gill, MB BChir, BSc, FRCS, UNITED KINGDOM McMeniman J Peter, AUSTRALIA Timothy John Mcmeniman, MBBS(Med)/MBBS, FRACS FA(Orth)A, AUSTRALIA Daniel Johnson Brimm, BSc, MD, AUSTRALIA Peter T. Myers, AM, MBBS, FRACS, FAOrthA, AUSTRALIA

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Tibial Morphology for Proper Adjustment of Metal Augmentation in Revision Total Knee Arthroplasty

Tibial Morphology for Proper Adjustment of Metal Augmentation in Revision Total Knee Arthroplasty

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Conclusions

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Tibial Morphology for Proper Adjustment of Metal Augmentation in Revision Total Knee Arthroplasty

Tibial Morphology for Proper Adjustment of Metal Augmentation in Revision Total Knee Arthroplasty

Background

Materials And Methods

Results

Conclusions

More 2023 ISAKOS Congress Content