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Oversizing the tibial component in TKAs: incidence, consequences and risk factors

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The incidence of anteroposterior overhang of the tibial component after TKA and its effect on clinical outcome were investigated, and the morphometric characteristics of the knees in which tibial baseplates were oversized were identified.

Method

One hundred and fourteen consecutive TKAs were retrospectively assessed. The dimensions of the tibia were measured on a pre-operative CT scan and were compared with those of the implanted tibial component. We analysed the effect of anteroposterior and mediolateral size variations on clinical outcomes 1 year after surgery.

Results

An anteroposterior overhang was observed in 87 % of cases on the lateral plateau, in 88 % on the central plateau and in 25 % on the medial tibial plateau. The mean post–pre-operative size differences were 3.2 ± 2.7, 2.8 ± 2.7 and −1.6 ± 2.3 mm, respectively. (Positive value means oversizing). A mediolateral overhang of the tibial component was found in 61 % of the patients. Oversizing was significantly greater and more frequent in females. Patients oversized in the anteroposterior dimension had lower post-operative pain scores. Patients with mediolateral oversizing had decreased flexion 1 year after surgery. Anteroposterior oversizing was observed more frequently in patients with asymmetric tibial plateaus, while mediolateral oversizing was observed more frequently in patients with small tibias.

Conclusions

This study demonstrates that the incidence of oversized tibial plateau components is surprisingly high and that functional outcomes are lower in the case of mediolateral or anteroposterior oversizing. The risk of oversizing could be predicted as it occurs predominantly in patients with asymmetric proximal tibia and/or small tibia.

Level of evidence

IV.

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Acknowledgments

No benefits or funds were received in support of the study.

Conflict of interest

One of the authors (M. B.) has received royalties from Tornier, Montbonnot, France.

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Authors and Affiliations

  1. Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008, Lyon, France

    Michel P. Bonnin & David Shepherd

  2. Accelerate Innovation Management, 1 rue de la navigation, 1201, Geneva, Switzerland

    Mo Saffarini

  3. Service de Biostatistique, Hospices Civils de Lyon, 69424, Lyon, France

    Nadine Bossard & Emmanuelle Dantony

  4. Université Lyon I, 69622, Villeurbanne, France

    Nadine Bossard & Emmanuelle Dantony

  5. CNRS, UMR 5558, Laboratoire Biostatistique Santé, 69495, Pierre-Bénite, France

    Nadine Bossard & Emmanuelle Dantony

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  1. Michel P. Bonnin
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  2. Mo Saffarini
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  4. Nadine Bossard
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  5. Emmanuelle Dantony
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Correspondence to Michel P. Bonnin.

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Bonnin, M.P., Saffarini, M., Shepherd, D. et al. Oversizing the tibial component in TKAs: incidence, consequences and risk factors. Knee Surg Sports Traumatol Arthrosc 24, 2532–2540 (2016). https://doi.org/10.1007/s00167-015-3512-0

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  • DOI: https://doi.org/10.1007/s00167-015-3512-0

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