Abstract
Introduction
The stem/keel location varies between anatomic and symmetric revision tibial baseplates. The current study investigates the impact of an anatomic versus symmetric stem location on the need for offset couplers in revision total knee arthroplasty.
Materials and methods
Hip to ankle standing radiographs and lateral radiographs of 75 patients were analyzed using digital templating software. The offset in the anterior–posterior as well as medial–lateral plane between the center of the tibial diaphysis and the stem of the tibial baseplate were determined for an anatomic and symmetric tibial baseplate, respectively. Measurements were repeated for 4 resection levels: tip of fibular head (0), 10 mm (1), 15 mm (2) and 20 mm (3) below the tip of the fibula head.
Results
Anatomic tibial baseplates require less offset for resection levels up to the tip of the fibula: total offset 2.28 versus 5.44 mm (p < 0.001). However, for defects that result in resection levels below the tip of the fibula symmetric tibial baseplates require less offset: resection level 1: 3.18 versus 2.4 mm (p = 0.008), 2: 4.81 versus 1.67 mm (p < 0.001) and resection level 3: 5.66 versus 1.52 mm (P < 0.001).
Conclusion
The current study suggests that while asymmetric anatomic tibial baseplates have benefits for revisions with minimal bone loss, symmetric tibial baseplates require less offset when larger bone defects are encountered.
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The senior author is a consultant with Smith & Nephew (Memphis, TN, USA). Dr. Boettner reports personal fees from Smith and Nephew, personal fees from Ortho Development Corporation and personal fees from DePuy, outside the submitted work.
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The study was approved by the institutional review board.
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Foruria, X., Schmidt-Braekling, T., Nabarte, D.A. et al. Does the tibia component design affect the need for offset stems in revision total knee arthroplasty?. Arch Orthop Trauma Surg 137, 853–860 (2017). https://doi.org/10.1007/s00402-017-2677-z
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DOI: https://doi.org/10.1007/s00402-017-2677-z