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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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Quality of Life Following Primary Total Knee Arthroplasty: Factors Predicting Satisfaction in Low-Income Population ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Houssem Eddine Chahed, MD, TUNISIA Ahmed Zendeoui, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Anis Tebourbi, MD, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
The Statistical Fragility of Tourniquet Use In Total Knee Arthroplasty: A Systematic Review ePoster Presentation Kyle William Lawrence, BS, UNITED STATES John K Cordero, MD, UNITED STATES Ashley Brown, BS, UNITED STATES Xinning Li, MD, UNITED STATES Brett Hayden, MD, UNITED STATES Robert L Parisien, MD, UNITED STATES
Association Of Ischemia Time And Serum Lactate Levels With Postoperative Pain In Primary Total Knee Arthroplasty At The Orthopedics And Traumatology Service At The Unidad Médica De Alta Especialidad No. 1 Bajío. ePoster Presentation Juan Antonio García Ramírez, MD, MEXICO
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
Clinical Comparison and Survival Rate Between Unicompartmental Knee Arthroplasty and High Tibial Osteotomy With An External Fixator For Varus Knee In Patients Younger Than 60 Years at Mid-Term Follow-Up ePoster Presentation Amit Kumar Yadav, M.S (Orth),DNB(Orth),MNAMS, UNITED KINGDOM Riccardo D'Ambrosi, MD, ITALY Mangal Parihar, MS Ortho, INDIA
Short-Term Clinical Outcome Of Functionally Aligned Robotic-Assisted BCS TKA is Better Than That Of Mechanically Aligned Navigation-Assisted BCS TKA ePoster Presentation Daisuke Hamada, MD, PhD, JAPAN Keizo Wada, MD, JAPAN Yasuaki Tamaki, MD, JAPAN Yasuyuki Omichi, MD, JAPAN Tomohiro Goto, MD, PhD, JAPAN Koichi Sairyo, MD, PhD, JAPAN
The Functional Outcome of Zimmer Biomet’s Nexgen Total Knee Arthroplasty as Compared with Healthy Older Adults ePoster Presentation Gwenllian F. Tawy, PhD, MRes, BSc(Hons), UNITED KINGDOM Michael J. McNicholas, BSc, MD, FRCS Tr & Orth, UNITED KINGDOM Leela C. Biant, MS, MFSTEd, FRCSEd(Tr&Orth), UNITED KINGDOM
Does 1000 Mg Ferric Carboxylate Maltose Have an Additional Benefit on the Haemoglobin Recovery Post Total Knee Arthroplasty? - A Comparison with 500 Mg of Ferric Carboxymaltose ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Ashwini Khokhar, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Naveen Chandar, MBBS, INDIA Abhinav Mishra, MS, DNB, INDIA Rajesh Maniar, INDIA
Advanced Active Robotic Technology for Total Knee Arthroplasty: A Learning Curve of Operative Time and Alignment Accuracy ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF Dong-Hoon Lee, MD, KOREA, REPUBLIC OF Hyun-Chul Nam, MD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF
Comparison of Outcomes between Fungal and Non-fungal Periprosthetic Joint Infections in Total Knee Arthroplasty: A Propensity Score-Matched Analysis ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Combined Fixed-Bearing Unicompartmental Knee Arthroplasty and Anterior Cruciate Ligament Reconstruction ePoster Presentation Claudio Legnani, MD, ITALY Enrico Borgo, MD, ITALY Vittorio Macchi, MD, ITALY Alberto Ventura, MD, ITALY
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

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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