Summary: Surgeons should be aware of this occurrence of size differences to avoid improperly sizing the second knee based only on its contralateral counterpart.

Introduction

The importance of anatomic variation in knee replacement prosthesis selection has gained popularity, encouraging more prosthesis size options for proposed customization and personalization. Size differences can also occur between knees of the same individual. The purpose of this study is to evaluate the frequency of anatomic variation between knees within the same patient and to determine whether outcomes differ depending on the component size.

Methods

From 2008-2017, 530 patients underwent staged or simultaneous bilateral knee replacements by a single surgeon. Of the 1060 procedures, there were 400 simultaneous TKAs and 660 staged procedures. Patients had an average of 70 at time of the first surgery, and BMI of 30. Patients were evaluated for perioperative complications and by clinical outcomes. Radiographs were evaluated for implant positioning and appropriateness of size.

Results

Component sizes differed within the same patient in 36.2% (384/1060). Femoral sizes differed in 50 patients (4.7%), the tibia 55 (5.2%), the patella 46 (4.3%), and liner 233 (22.0%). In 12 patients, the femur and tibia simultaneously differed in size from one knee to the other. The liner size differed simultaneously with 14 patients with differing femurs, and was thicker in 13 knees with larger tibial components, and thicker in 9 with smaller tibial components. Tibial size did not seem dependent on depth of tibial resection as the tibial insert thickness did not correlate with smaller tibial sizes (p=0.47).

Discussion

Liner thickness most frequently varies between knees, but femoral, tibial, and patellar component sizes can also differ with some regularity. Surgeons should be aware of this occurrence of size differences to avoid improperly sizing the second knee based only on its contralateral counterpart. The variability in prosthesis size is appropriate anatomically and leads to comparable outcomes compared to the contralateral knee.

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Success of Debridement, Antibiotics, and Implant Retention vs Revision In Early And Late Prosthetic Joint Infections Following Primary TKA: A Prospective, Multicenter Study of 251 Cases ePoster Presentation Mark Zhu, MBChB, NEW ZEALAND Richard Rahardja, MBChB, BMedSc(Hons), NEW ZEALAND Laurens Manning, MBChB, AUSTRALIA Sarah Metcalf, MBChB, NEW ZEALAND Simon W. Young, MD, FRACS, NEW ZEALAND
Knee Arthroscopy Prior to UKA Does Not Cause Infection ePoster Presentation Kevin D. Plancher, MD, MPH, UNITED STATES Karen Briggs, MPH, UNITED STATES Stephanie C. Petterson, MPT, PhD, 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
Time-Driven Activity-Based Costs for Manipulation Under Anesthesia after Total Knee Arthroplasty ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Suzanne Kent, MD, UNITED STATES John Mazzocco, MD, UNITED STATES Lauren Schoeller, BS, UNITED STATES Ruijia Niu, MPH, UNITED STATES Daniel C Sun, UNITED STATES Eric L. Smith, MD, UNITED STATES
Tibial Morphology for Proper Adjustment of Metal Augmentation in Revision Total Knee Arthroplasty ePoster Presentation 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
Bicruciate Substituting Total Knee Arthroplasty Improved Anteroposterior Displacement in Mid-Flexion Range ePoster Presentation Keinosuke Ryu, Prof., JAPAN Takanori Iriuchisima, MD, JAPAN
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
Detection Loosening of Total Knee Arthroplasty Implant from Plain Radiograph Using Machine Learning Algorithm 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
Patellofemoral Arthroplasty In Community Programs: Case Series of 425 Patients ePoster Presentation Alexander P. Sah, MD, UNITED STATES

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Implant Size and Outcome Differences of Knees in Same Patient for Simultaneous vs Staged Bilateral TKA

Implant Size and Outcome Differences of Knees in Same Patient for Simultaneous vs Staged Bilateral TKA

Introduction

Methods

Results

Discussion

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Implant Size and Outcome Differences of Knees in Same Patient for Simultaneous vs Staged Bilateral TKA

Implant Size and Outcome Differences of Knees in Same Patient for Simultaneous vs Staged Bilateral TKA

Introduction

Methods

Results

Discussion

More 2023 ISAKOS Congress Content