Availability of Additional Mediolateral Implant Option During Total Knee Arthroplasty Improves Femoral Component Fit Across Ethnicities
Background:. Anatomical variation may represent a challenge in achieving a close fit between a prosthesis and a patient’s osseous geometry in total knee arthroplasty (TKA). The purposes of this study were to determine whether the shape of the distal part of the femur differs among ethnicities, wheth...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2017-06-01
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| Series: | JBJS Open Access |
| Online Access: | http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.16.00014 |
| _version_ | 1819077689556860928 |
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| author | Gaurav Sharma, MS(Orth) David Liu, FRACS Rajesh Malhotra, MS(Orth), FRCS Yi Xin Zhou, MD, PhD Masao Akagi, MD, PhD T.K. Kim, MD, PhD |
| author_facet | Gaurav Sharma, MS(Orth) David Liu, FRACS Rajesh Malhotra, MS(Orth), FRCS Yi Xin Zhou, MD, PhD Masao Akagi, MD, PhD T.K. Kim, MD, PhD |
| author_sort | Gaurav Sharma, MS(Orth) |
| collection | DOAJ |
| description | Background:. Anatomical variation may represent a challenge in achieving a close fit between a prosthesis and a patient’s osseous geometry in total knee arthroplasty (TKA). The purposes of this study were to determine whether the shape of the distal part of the femur differs among ethnicities, whether these differences affect the fit of the femoral component of a standard prosthesis, and whether the additional availability of a femoral component with a reduced mediolateral dimension for the same anteroposterior dimension improves femoral component fit across ethnicities.
Methods:. Femoral dimensions were measured intraoperatively during 967 TKAs performed using the same type of prosthesis in patients of 5 different ethnicities. Aspect ratios were calculated to determine whether the shapes of the femora differed among ethnicities. The component fit (“perfect,” overhang, or underhang) when only standard prostheses were available was compared with the fit when both standard and narrow prostheses were available in all ethnic groups. This enabled us to determine whether the femoral component fit was improved by the additional availability of the narrow version.
Results:. Wide variations in shape were found among ethnicities as were variations among individuals of the same ethnicity. Differences in shape among ethnicities influenced the rate of overhang. However, overhang was more frequent at the trochlear than at the condylar level across all ethnicities. The availability of both the standard and the narrow femoral components improved the rate of a perfect fit in women in 3 of the 5 ethnic groups and reduced the overhang rate in women in all 5 of the ethnic groups. In contrast, only modest improvements in femoral component fit, which were not statistically significant, were seen in men.
Conclusions:. The shape of the distal part of the femur varies not only among ethnicities but also within ethnic groups, leading to a high prevalence of overhang when only standard prostheses are available. The additional availability of a femoral component with a reduced mediolateral dimension for the same anteroposterior size can reduce overhang and improve component fit across ethnicities. |
| first_indexed | 2024-12-21T19:01:12Z |
| format | Article |
| id | doaj.art-09a7640be662434db7c06219e0f0c2ff |
| institution | Directory Open Access Journal |
| issn | 2472-7245 |
| language | English |
| last_indexed | 2024-12-21T19:01:12Z |
| publishDate | 2017-06-01 |
| publisher | Wolters Kluwer |
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| series | JBJS Open Access |
| spelling | doaj.art-09a7640be662434db7c06219e0f0c2ff2022-12-21T18:53:28ZengWolters KluwerJBJS Open Access2472-72452017-06-0122e001410.2106/JBJS.OA.16.00014JBJSOA-D-16-00014Availability of Additional Mediolateral Implant Option During Total Knee Arthroplasty Improves Femoral Component Fit Across EthnicitiesGaurav Sharma, MS(Orth)0David Liu, FRACS1Rajesh Malhotra, MS(Orth), FRCS2Yi Xin Zhou, MD, PhD3Masao Akagi, MD, PhD4T.K. Kim, MD, PhD51Joint Reconstruction Center, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea2Gold Coast Centre for Bone and Joint Surgery, John Flynn Private Hospital, Gold Coast, Queensland, Australia3Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India4Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China5Department of Orthopaedic Surgery, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan1Joint Reconstruction Center, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of KoreaBackground:. Anatomical variation may represent a challenge in achieving a close fit between a prosthesis and a patient’s osseous geometry in total knee arthroplasty (TKA). The purposes of this study were to determine whether the shape of the distal part of the femur differs among ethnicities, whether these differences affect the fit of the femoral component of a standard prosthesis, and whether the additional availability of a femoral component with a reduced mediolateral dimension for the same anteroposterior dimension improves femoral component fit across ethnicities. Methods:. Femoral dimensions were measured intraoperatively during 967 TKAs performed using the same type of prosthesis in patients of 5 different ethnicities. Aspect ratios were calculated to determine whether the shapes of the femora differed among ethnicities. The component fit (“perfect,” overhang, or underhang) when only standard prostheses were available was compared with the fit when both standard and narrow prostheses were available in all ethnic groups. This enabled us to determine whether the femoral component fit was improved by the additional availability of the narrow version. Results:. Wide variations in shape were found among ethnicities as were variations among individuals of the same ethnicity. Differences in shape among ethnicities influenced the rate of overhang. However, overhang was more frequent at the trochlear than at the condylar level across all ethnicities. The availability of both the standard and the narrow femoral components improved the rate of a perfect fit in women in 3 of the 5 ethnic groups and reduced the overhang rate in women in all 5 of the ethnic groups. In contrast, only modest improvements in femoral component fit, which were not statistically significant, were seen in men. Conclusions:. The shape of the distal part of the femur varies not only among ethnicities but also within ethnic groups, leading to a high prevalence of overhang when only standard prostheses are available. The additional availability of a femoral component with a reduced mediolateral dimension for the same anteroposterior size can reduce overhang and improve component fit across ethnicities.http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.16.00014 |
| spellingShingle | Gaurav Sharma, MS(Orth) David Liu, FRACS Rajesh Malhotra, MS(Orth), FRCS Yi Xin Zhou, MD, PhD Masao Akagi, MD, PhD T.K. Kim, MD, PhD Availability of Additional Mediolateral Implant Option During Total Knee Arthroplasty Improves Femoral Component Fit Across Ethnicities JBJS Open Access |
| title | Availability of Additional Mediolateral Implant Option During Total Knee Arthroplasty Improves Femoral Component Fit Across Ethnicities |
| title_full | Availability of Additional Mediolateral Implant Option During Total Knee Arthroplasty Improves Femoral Component Fit Across Ethnicities |
| title_fullStr | Availability of Additional Mediolateral Implant Option During Total Knee Arthroplasty Improves Femoral Component Fit Across Ethnicities |
| title_full_unstemmed | Availability of Additional Mediolateral Implant Option During Total Knee Arthroplasty Improves Femoral Component Fit Across Ethnicities |
| title_short | Availability of Additional Mediolateral Implant Option During Total Knee Arthroplasty Improves Femoral Component Fit Across Ethnicities |
| title_sort | availability of additional mediolateral implant option during total knee arthroplasty improves femoral component fit across ethnicities |
| url | http://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.16.00014 |
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