Summary: Excessive joint line obliquity can occur when calipered KA TKA is performed in Japanese patients with varus OA knees, and surgeons should consider employing modifications when determining the coronal alignment of the proximal tibial cut for calipered KA TKA in these patients.

Background

Calipered kinematically aligned total knee arthroplasty (KA TKA) has been reported to provide promising clinical results and higher long-term survival rates. The tibia is prone to excessive varus deformity in the Japanese population, which can cause excessive joint line obliquity after calipered KA TKA. The purpose of this study was to elucidate the joint line angle on the distal femur and proximal tibia in patients undergoing TKA in Japan and to determine the risk of significant obliquity of the osteotomy surface using the calipered KA TKA method.

Methods

Forty-four patients (50 consecutive knees) with osteoarthritis (OA) awaiting TKA were chosen as study participants. We simulated the calipered KA TKA measurements based on preoperative computed tomography (CT) images using planning software (ZedKnee; LEXI, Tokyo, Japan). Surgical simulation was performed using LEGION CR. After considering the 9-mm thickness of the implants and 2-mm thickness of the cartilage, the distal and posterior femur and proximal tibia were resected at 7 mm. We investigated the lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and hip-knee-ankle angle (HKA) from the simulated calipered KA TKA measurements.

Results

The mean MPTA was -5.9° ± 2.5° (-11.8° to -0.5°), and 68% of patients showed a MPTA of < -5°. The mean LDFA was 2.4° ± 3.1° (-6.6° to 10.3°), and 20% of patients showed an LDFA of > 5°. The mean HKA was -3.6° ± 3.6° (-10.6° to 2.8°), with 38% of patients showing a HKA of < -5°.

Conclusions

Excessive joint line obliquity can occur when calipered KA TKA is performed in Japanese patients with varus OA knees. Surgeons should consider modifications when determining the coronal alignment of the proximal tibial cut for calipered KA TKA in these patients.

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Differences In Pain, Sleep Status And Functional Recovery Between TKA And UKA ePoster Presentation Takeo Mammoto, MD, JAPAN
Association Between The Femoral And Tibial Component Positions and Intraoperative Knee Kinematics In Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Effect of Direct Adductor Canal Block Performed by a Surgeon in a Patient Who Underwent Simultaneous Bilateral TKA ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Patella in Total Knee Replacement: Patellar Resurfacing has Better Outcomes than Lateral Facetectomy at One Year Follow-Up ePoster Presentation Tomas Alfredo Esteves, MD, ARGENTINA Matias Novillo, MD, ARGENTINA Tomas Nicolino, MD, ARGENTINA Matias Costa-Paz, MD, PhD, ARGENTINA Lisandro Carbó, MD, ARGENTINA Julian Costantini, MD, ARGENTINA
In-Vivo Kinematic Analysis of Evolution® Medial-Pivot Total Knee Arthroplasty during Weight-Bearing Activity ePoster Presentation Eiichi Nakamura, MD, PhD, JAPAN Nobukazu Okamoto, MD, PhD, JAPAN Hitoshi Ito, MD, PhD, JAPAN Tetsurou Masuda, MD, PhD, JAPAN Satoshi Hisanaga, MD, PhD, JAPAN Yasunari Oniki, MD, PhD, JAPAN
Antibiotic-Loaded Bone Cement with Colistin at Erythromycin Do Not Decrease Chronic TKA Pji at a Long-Term ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Pedro Hinarejos, MD, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
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
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
Factors Associated With Failure and Survivorship Following Unicompartmental Knee Arthroplasty: A Single-Center Experience ePoster Presentation Anirudh K Gowd, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES Asher Lichtig, MD, UNITED STATES Orhan Yanmis, MD, UNITED STATES Gary G. Poehling, MD, UNITED STATES
Implant Size and Outcome Differences of Knees in Same Patient for Simultaneous vs Staged Bilateral TKA ePoster Presentation Alexander P. Sah, MD, UNITED STATES

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Calipered Measurements Method For Kinematically Aligned Total Knee Arthroplasty Has A Risk Of Excessive Varus Cut For The Proximal Tibia In Japanese Varus Knees

Calipered Measurements Method For Kinematically Aligned Total Knee Arthroplasty Has A Risk Of Excessive Varus Cut For The Proximal Tibia In Japanese Varus Knees

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Calipered Measurements Method For Kinematically Aligned Total Knee Arthroplasty Has A Risk Of Excessive Varus Cut For The Proximal Tibia In Japanese Varus Knees

Calipered Measurements Method For Kinematically Aligned Total Knee Arthroplasty Has A Risk Of Excessive Varus Cut For The Proximal Tibia In Japanese Varus Knees

Background

Methods

Results

Conclusions

More 2023 ISAKOS Congress Content