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CT Morphometric Analysis of Medial Tibial Condyles: Are the Currently Available Designs of Unicompartmental Knee Arthroplasty Suitable for Indian Knees?

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Abstract

Background

The main purpose of this study is to assess the compatibility of medial tibial condyle (MTC) morphometry of Indian population with that of six contemporary UKA prostheses tibial components. We hypothesized that from the currently available UKA designs at least one would fit the MTC morphometry optimally as per the manufacturer’s recommendation.

Methods

We used CT morphometric data of 100 (66 males and 34 females) consecutive nonarthritic adult knees with reference to the MTC to assess the compatibility of currently available (in India) UKA prostheses. Each MTC was measured in the anteroposterior dimension, mediolateral at pre-defined points and the MTC aspect ratio calculated. Proportion of knees which could be optimally fitted with the existing UKA tibial components was calculated.

Results

The mean age was 39.6 (SD 15.9) years. Anteroposterior and mediolateral dimensions in males were higher as compared to females (p < 0.001). As the anteroposterior dimension increased, the MTC aspect ratio decreased. There was asymmetry of anteroposterior halves with maximum mediolateral width being posterior to the central mediolateral width by 5.5 (SD 2.8) mm. Optimal anteroposterior fit ranged from 66 to 93%. However, optimal mediolateral fit as well, ranged from 5 to 37% with underhang present in 17–61% and > 2 mm medial overhang present in 0–35% cases. In 23% of cases, not a single implant could be fitted optimally.

Conclusion

Currently available UKA implants do not provide optimal tibial fit in nearly 25% of Indian patients. A surgeon needs to be aware of these limitations of existing implants when considering UKA.

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Availability of Data and Material

The data generated during and analyzed during the current study are available from the corresponding author on request.

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Acknowledgements

This paper presents independent research supported by the National Institute for Health Research (NIHR) Leeds Biomedical Research Centre (BRC). Professor Pandit is a NIHR Senior Investigator. The views expressed in this article are those of the author(s) and not necessarily those of the NIHR, or the Department of Health and Social Care.

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No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Orthopaedics, Seth G S Medical College and KEM Hospital, Parel, Mumbai, 400012, India

    Radhakrishna Kantanavar & Mohan Madhav Desai

  2. Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK

    Hemant Pandit

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  1. Radhakrishna Kantanavar
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Correspondence to Mohan Madhav Desai.

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The author C reports grants and personal fees from Zimmer Biomet, personal fees from Smith and Nephew, grants and personal fees from Depuy Synthes, personal fees from Medacta International, personal fees from Meril Life, grants from Invibio, grants and personal fees from GSK, personal fees from JRI, outside the submitted work.

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Kantanavar, R., Desai, M.M. & Pandit, H. CT Morphometric Analysis of Medial Tibial Condyles: Are the Currently Available Designs of Unicompartmental Knee Arthroplasty Suitable for Indian Knees?. JOIO 55, 1135–1143 (2021). https://doi.org/10.1007/s43465-021-00429-y

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