Morphologic difference and size mismatch in the medial and lateral tibial condyles exist with respect to gender for unicompartmental knee arthroplasty in the Korean population

Abstract

Purpose

The purpose of this study was to characterize the geometry of the proximal tibia in both genders in the Korean population. Anthropometric data on the medial and lateral tibial condyles of the osteoarthritic knees of 149 males and 814 females were obtained using three-dimensional magnetic resonance imaging.

Methods

In the medial and lateral proximal tibial condyles, the anteroposterior (AP) dimension, widest dimension (WD) at defined points, and condylar aspect ratio were evaluated. These measurements were compared with similar dimensions of the tibial components from five commonly used unicompartmental knee arthroplasty (UKA) designs in Korea.

Results

Both the AP dimension and WD in the medial and lateral tibial condyles of the male patients were significantly greater than those of the female patients (P < 0.05). In addition, the AP dimension and WD were greater in the medial than in the lateral tibial condyle (P < 0.05). There was WD overhang in three and two prostheses in the medial and lateral tibial condyles, respectively. A decrease in the condylar aspect ratio with an increasing AP dimension was found in the medial and lateral tibial condyles for both the male and female patients.

Conclusions

Smaller medial and lateral tibial condylar dimensions are more frequent in Korean women than in Korean men. This study highlights the finding that conventional UKA designs lead to size mismatch in the Korean population and may indicate an important guideline on proper gender-specific UKA tibial prostheses with different WD/AP dimension aspect ratios. In addition, this study suggests that the shape of the medial tibial plateau is different to that of the lateral plateau, which can lead to a mediolateral overhang for medial UKA in an attempt to optimize the AP coverage.

Level of evidence

III.

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References

  1. 1.

    Bare JV, Gill HS, Beard DJ, Murray DW (2006) A convex lateral tibial plateau for knee replacement. Knee 13:122–126

    CAS  Article  Google Scholar 

  2. 2.

    Berger RA, Nedeff DD, Barden RM, Sheinkop MM, Jacobs JJ, Rosenberg AG, Galante JO (1999) Unicompartmental knee arthroplasty. Clinical experience at 6- to 10-year followup. Clin Orthop Relat Res 367:50–60

    Article  Google Scholar 

  3. 3.

    Bothra V, Lemon G, Lang D, Smith DM, Ali AM (2003) Reliability of templating in estimating the size of uni-condylar knee arthroplasty. J Arthroplasty 18:780–783

    Article  Google Scholar 

  4. 4.

    Bruni D, Zaffagnini S, Iacono F, Bragonzoni L, Lo Presti M, Neri MP, Muccioli GM, Nitri M, Raspugli G, Marcacci M (2016) High rate of implant loosening for uncemented resurfacing-type medial unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 24:3175–3182

    Article  Google Scholar 

  5. 5.

    Carpenter DP, Holmberg RR, Quartulli MJ, Barnes CL (2014) Tibial plateau coverage in UKA: a comparison of patient specific and off-the-shelf implants. J Arthroplasty 29:1694–1698

    Article  Google Scholar 

  6. 6.

    Carr A, Keyes G, Miller R, O’Connor J, Goodfellow J (1993) Medial unicompartmental arthroplasty. A survival study of the Oxford meniscal knee. Clin Orthop Relat Res 295:205–213

    Google Scholar 

  7. 7.

    Chau R, Gulati A, Pandit H, Beard DJ, Price AJ, Dodd CA, Gill HS, Murray DW (2009) Tibial component overhang following unicompartmental knee replacement—does it matter? Knee 16:310–313

    CAS  Article  Google Scholar 

  8. 8.

    Cheng FB, Ji XF, Zheng WX, Lai Y, Cheng KL, Feng JC, Li YQ (2010) Use of anthropometric data from the medial tibial and femoral condyles to design unicondylar knee prostheses in the Chinese population. Knee Surg Sports Traumatol Arthrosc 18:352–358

    Article  Google Scholar 

  9. 9.

    Demange MK, Von Keudell A, Probst C, Yoshioka H, Gomoll AH (2015) Patient-specific implants for lateral unicompartmental knee arthroplasty. Int Orthop 39:1519–1526

    Article  Google Scholar 

  10. 10.

    Fehring TK, Odum SM, Masonis JL, Springer BD (2010) Early failures in unicondylar arthroplasty. Orthopedics 33:11

    Article  Google Scholar 

  11. 11.

    Fitzpatrick C, FitzPatrick D, Lee J, Auger D (2007) Statistical design of unicompartmental tibial implants and comparison with current devices. Knee 14:138–144

    Article  Google Scholar 

  12. 12.

    Furnes O, Espehaug B, Lie SA, Vollset SE, Engesaeter LB, Havelin LI (2007) Failure mechanisms after unicompartmental and tricompartmental primary knee replacement with cement. J Bone Joint Surg Am 89:519–525

    CAS  Article  Google Scholar 

  13. 13.

    Gudena R, Pilambaraei MA, Werle J, Shrive NG, Frank CB (2013) A safe overhang limit for unicompartmental knee arthroplasties based on medial collateral ligament strains: an in vitro study. J Arthroplasty 28:227–233

    Article  Google Scholar 

  14. 14.

    Hashemi J, Chandrashekar N, Gill B, Beynnon BD, Slauterbeck JR, Schutt RC Jr, Mansouri H, Dabezies E (2008) The geometry of the tibial plateau and its influence on the biomechanics of the tibiofemoral joint. J Bone Joint Surg Am 90:2724–2734

    Article  Google Scholar 

  15. 15.

    Hitt K, Shurman JR 2nd, Greene K, McCarthy J, Moskal J, Hoeman T, Mont MA (2003) Anthropometric measurements of the human knee: correlation to the sizing of current knee arthroplasty systems. J Bone Joint Surg Am 85-A(Suppl 4):115–122

    Article  Google Scholar 

  16. 16.

    Hofmann AA, Bachus KN, Wyatt RW (1991) Effect of the tibial cut on subsidence following total knee arthroplasty. Clin Orthop Relat Res 269:63–69

    Google Scholar 

  17. 17.

    Kang KT, Kim SH, Son J, Lee YH, Kim S, Chun HJ (2017) Probabilistic evaluation of the material properties of the in vivo subject-specific articular surface using a computational model. J Biomed Mater Res B Appl Biomater 105:1390–1400

    CAS  Article  Google Scholar 

  18. 18.

    Kang KT, Son J, Kwon OR, Baek C, Heo DB, Park KM, Kim HJ, Koh YG (2017) Effects of measurement methods for tibial rotation axis on the morphometry in Korean populations by gender. Knee 24:23–30

    Article  Google Scholar 

  19. 19.

    Koh YG, Nam JH, Chung HS, Kim HJ, Chun HJ, Kang KT (2018) Gender differences in morphology exist in posterior condylar offsets of the knee in Korean population. Knee Surg Sports Traumatol Arthrosc 27:1628–1634

    Article  Google Scholar 

  20. 20.

    Koskinen E, Paavolainen P, Eskelinen A, Pulkkinen P, Remes V (2007) Unicondylar knee replacement for primary osteoarthritis: a prospective follow-up study of 1,819 patients from the Finnish Arthroplasty Register. Acta Orthop 78:128–135

    Article  Google Scholar 

  21. 21.

    Lonner JH, Jasko JG, Thomas BS (2008) Anthropomorphic differences between the distal femora of men and women. Clin Orthop Relat Res 466:2724–2729

    Article  Google Scholar 

  22. 22.

    Mensch JS, Amstutz HC (1975) Knee morphology as a guide to knee replacement. Clin Orthop Relat Res 112:231–241

    Google Scholar 

  23. 23.

    Nunley RM, Ellison BS, Zhu J, Ruh EL, Howell SM, Barrack RL (2012) Do patient-specific guides improve coronal alignment in total knee arthroplasty? Clin Orthop Relat Res 470:895–902

    Article  Google Scholar 

  24. 24.

    Riddle DL, Jiranek WA, McGlynn FJ (2008) Yearly incidence of unicompartmental knee arthroplasty in the United States. J Arthroplasty 23:408–412

    Article  Google Scholar 

  25. 25.

    Rougraff BT, Heck DA, Gibson AE (1991) A comparison of tricompartmental and unicompartmental arthroplasty for the treatment of gonarthrosis. Clin Orthop Relat Res 273:157–164

    Google Scholar 

  26. 26.

    Servien E, Aitsiselmi T, Neyret P, Verdonk P (2007) How to select candidates for lateral unicompartmental prosthesis. Techn Knee Surg 6:51–59

    Article  Google Scholar 

  27. 27.

    Servien E, Saffarini M, Lustig S, Chomel S, Neyret P (2008) Lateral versus medial tibial plateau: morphometric analysis and adaptability with current tibial component design. Knee Surg Sports Traumatol Arthrosc 16:1141–1145

    CAS  Article  Google Scholar 

  28. 28.

    Surendran S, Kwak DS, Lee UY, Park SE, Gopinathan P, Han SH, Han CW (2007) Anthropometry of the medial tibial condyle to design the tibial component for unicondylar knee arthroplasty for the Korean population. Knee Surg Sports Traumatol Arthrosc 15:436–442

    Article  Google Scholar 

  29. 29.

    Vaidya SV, Ranawat CS, Aroojis A, Laud NS (2000) Anthropometric measurements to design total knee prostheses for the Indian population. J Arthroplasty 15:79–85

    CAS  Article  Google Scholar 

  30. 30.

    Vince KG, Cyran LT (2004) Unicompartmental knee arthroplasty: new indications, more complications? J Arthroplasty 19:9–16

    Article  Google Scholar 

  31. 31.

    Wada K, Hamada D, Takasago T, Nitta A, Goto T, Tonogai I, Tsuruo Y, Sairyo K (2018) Native rotational knee kinematics is restored after lateral UKA but not after medial UKA. Knee Surg Sports Traumatol Arthrosc 26:3438–3443

    Article  Google Scholar 

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Correspondence to Kyoung-Tak Kang.

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Koh, YG., Nam, JH., Chung, HS. et al. Morphologic difference and size mismatch in the medial and lateral tibial condyles exist with respect to gender for unicompartmental knee arthroplasty in the Korean population. Knee Surg Sports Traumatol Arthrosc 28, 1789–1796 (2020). https://doi.org/10.1007/s00167-019-05600-5

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Keywords

  • Unicondylar knee arthroplasty
  • Korean patients
  • Morphometry analysis
  • Tibial component
  • Implant size