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Tibial implant design in primary TKA: retrospective comparison of two designs for the occurrence of radiolucent lines and aseptic loosening

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this retrospective study was to study the effect of tibial implant design on the occurrence of radiolucent lines (RLLs) and aseptic loosening (AL) by comparing two different total knee arthroplasty (TKA) designs.

Materials and methods

Two types of total knee arthroplasty, different for tibial shape, size and keel design were compared, 255 for the first and 774 for the second. The occurrence of RLLs and radiological signs of micro- and macro-mobility and aseptic loosening was analyzed. Demographic data were compared, as well as the type and rate of RLLs, occurrence of aseptic loosening and the presence of potential risk factors.

Results

The first implant design is morphometric and has a squarer keel than the second implant TKA. The overall rate of RLLs was similar (21% vs 23%), despite of a significantly lower rates of radiological signs of macro-mobility of the tibial component with the first implant (2% vs 17%). Survivorship of both designs was overall comparable (99.6% vs 98.8 %) the first implant group had more potential risk factors for poor bone quality than the second group (p < 0.05).

Conclusion

A morphometric design is more anatomic and offers better bone coverage of the epiphyseal tibial surface. RLLs, as a sign of implant micro-mobility, were equally present in both designs. Radiological signs of macro-mobility at the metaphysis were less frequently observed in squared keel design. The morphometric implant did not show improved survivorship compared with a symmetric implant.

Level of evidence

III.

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Data will be available on request.

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Acknowledgements

We thank the Mont-Godinne Foundation, who supported one author (DW), by an intramural grant.

Funding

One author (DW) has received funding from Mont-Godinne foundation.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, CHU UCL Namur, Godinne, Avenue Docteur Gaston Therasse 1, 5530, Yvoir, Belgium

    D. Wautier

  2. Department of Orthopedic Surgery, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium

    E. Thienpont

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Correspondence to D. Wautier.

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Conflict of interest

One author (DW) declares no conflict of interest in regard to this work. One author (ET) reports personal fees from Conformis (Billerica, MA, US) in the amount of USD 10,000-USD 100,000, Lima (Udine, Italy) in the amount of USD 10,000-USD 100,000; Zimmer Biomet (Warsaw, IN, US) in the amount of USD 10,000-USD 100,000. The author (ET) has received royalties for a patent from Conformis (Billerica, MA, US), Lima (Udine, Italy) and Zimmer Biomet (Warsaw, IN, US). The author (ET) has received institutional research support from Zimmer Biomet (Warsaw, IN, US) for an amount of USD 10,000–100,000.

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All investigations are conformed to the Declaration of Helsinki and are approved by the ethical committee of Comité Ethique Hospitalo-Facultaire Saint-Luc-UCL: 2017/10MAI/262.

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Wautier, D., Thienpont, E. Tibial implant design in primary TKA: retrospective comparison of two designs for the occurrence of radiolucent lines and aseptic loosening. Arch Orthop Trauma Surg 144, 323–332 (2024). https://doi.org/10.1007/s00402-023-05030-6

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