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Potential risk of medial cortex perforation due to peg position of morphometric tibial component in unicompartmental knee arthroplasty: a computer simulation study

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study is to evaluate the risk of medial tibial cortical perforation in unicompartmental knee arthroplasty (UKA) due to peg positions on the tibial tray of the Persona Partial Knee (PPK).

Methods

Preoperative CT images of 60 patients and 60 osteoarthritic knees (30 male and 30 female patients) were used. A tibial multiplanar reconstruction (MPR) image was reconstructed in preoperative planning software, and the implant was placed in a virtual osteotomy plane. In addition to PPK, Zimmer Unicompartmental Knee (ZUK) and TRIBRID (TBD) were used for evaluation. The horizontal distances from the medial tibial cortex to the anterior and posterior pegs (APCD/PPCD, respectively) were measured under neutral, 3-degree varus, 3-degree valgus and 2 mm distal positions. The differences between implants under the same positions and between positions using the same implants were compared. The percentage of total cases with APCD/PPCD of less than 3 mm and the perforation risk rate were calculated.

Results

The APCD of PPK was significantly shorter at all positions except for the varus position of TBD. The PPCD of PPK was significantly shorter at all positions compared to ZUK and TBD. There were no cases with an APCD of less than 3 mm. Except for varus positions, the perforation risk rate of PPCD was significantly higher for PPK than the other two implants.

Conclusion

The posterior pegs of the PPK are located more medially than the other two implants, which may result in perforation of the medial tibial cortex during implantation. Surgeons should consider the risk involved in the type of implant used.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan

    Keiji Tensho, Tomoya Iwaasa, Suguru Koyama, Hiroki Shimodaira, Hiroshi Horiuchi, Naoto Saito & Jun Takahashi

Authors
  1. Keiji Tensho
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  2. Tomoya Iwaasa
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  3. Suguru Koyama
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  4. Hiroki Shimodaira
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  5. Hiroshi Horiuchi
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  6. Naoto Saito
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  7. Jun Takahashi
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Contributions

KT, HS, TI, HH and JT: designed the study, analyzed the data and wrote the manuscript; KT, HH, and SK: performed experiments; HH, NS and JT: supervised the project.

Corresponding author

Correspondence to Keiji Tensho.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The regional ethical review board in Shinshu University, Japan, approved this study (Ref 4768).

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Tensho, K., Iwaasa, T., Koyama, S. et al. Potential risk of medial cortex perforation due to peg position of morphometric tibial component in unicompartmental knee arthroplasty: a computer simulation study. Knee Surg Sports Traumatol Arthrosc 30, 536–544 (2022). https://doi.org/10.1007/s00167-020-06242-8

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  • DOI: https://doi.org/10.1007/s00167-020-06242-8

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