Effects of tibial baseplate shape on rotational alignment in total knee arthroplasty

three-dimensional surgical simulation using osteoarthritis knees

Yuan Ma, Hideki Mizuuchi, Ken Okazaki, Tetsuro Ushio, Koji Murakami, Satoshi Hamai, Yukio Akasaki, Yasuharu Nakashima

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Placement of tibial component is expected to fulfill both maximum surface coverage and recommended anterior–posterior (AP) alignment in total knee arthroplasty (TKA). The purpose of this study is to evaluate the effect of the tibial baseplate shape on AP axis. Materials and methods: Virtual surgery of TKA was performed with three-dimensional bone models reconstructed from 77 osteoarthritis varus knees. Two differently designed tibial baseplates, symmetrically and anatomically, were set to the cut surface under posterior slopes of 0°, 3°, and 7°. The AP axes were defined by connecting the geometrical center of the cut surface with the medial edge (axis MED) and medial 1/3 (axis 1/3MED) of patella tendon attachment. We evaluated the overhang rates as well as the most fitting AP axis which passes through the geometric center. Results: Overhang rates when aligned to axis MED were 12–25% for the symmetrical-type group and 13–22% for the anatomical-type group. Overhang rates when aligned to axis 1/3MED were 42–48% for the symmetrical-type group and 3–7% for the anatomical-type group. The most fitting AP axis of tibial baseplate was located 2.5° external to axis MED for the symmetrical-type group and around 3.3° internal to axis 1/3MED for the anatomical-type group. Conclusions: Symmetrically or anatomically designed tibial baseplates have their own favored AP axis and specific performance on coverage. When aligned to axis 1/3MED, anatomically designed tibial baseplates will effectively lower the mismatch rates compared to a symmetrically designed tibial baseplate. Orthopaedic surgeons are expected to place the tibial components to the cut surface during TKA with full understanding of the features between different baseplate designs, AP axes, and posterior slopes for an ideal tibial rotational position.

Original languageEnglish
Pages (from-to)105-114
Number of pages10
JournalArchives of Orthopaedic and Trauma Surgery
Volume138
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

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Knee Replacement Arthroplasties
Knee Osteoarthritis
Patellar Ligament
Bone and Bones

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{57fe60348b414abbb07f64918332134b,
title = "Effects of tibial baseplate shape on rotational alignment in total knee arthroplasty: three-dimensional surgical simulation using osteoarthritis knees",
abstract = "Introduction: Placement of tibial component is expected to fulfill both maximum surface coverage and recommended anterior–posterior (AP) alignment in total knee arthroplasty (TKA). The purpose of this study is to evaluate the effect of the tibial baseplate shape on AP axis. Materials and methods: Virtual surgery of TKA was performed with three-dimensional bone models reconstructed from 77 osteoarthritis varus knees. Two differently designed tibial baseplates, symmetrically and anatomically, were set to the cut surface under posterior slopes of 0°, 3°, and 7°. The AP axes were defined by connecting the geometrical center of the cut surface with the medial edge (axis MED) and medial 1/3 (axis 1/3MED) of patella tendon attachment. We evaluated the overhang rates as well as the most fitting AP axis which passes through the geometric center. Results: Overhang rates when aligned to axis MED were 12–25{\%} for the symmetrical-type group and 13–22{\%} for the anatomical-type group. Overhang rates when aligned to axis 1/3MED were 42–48{\%} for the symmetrical-type group and 3–7{\%} for the anatomical-type group. The most fitting AP axis of tibial baseplate was located 2.5° external to axis MED for the symmetrical-type group and around 3.3° internal to axis 1/3MED for the anatomical-type group. Conclusions: Symmetrically or anatomically designed tibial baseplates have their own favored AP axis and specific performance on coverage. When aligned to axis 1/3MED, anatomically designed tibial baseplates will effectively lower the mismatch rates compared to a symmetrically designed tibial baseplate. Orthopaedic surgeons are expected to place the tibial components to the cut surface during TKA with full understanding of the features between different baseplate designs, AP axes, and posterior slopes for an ideal tibial rotational position.",
author = "Yuan Ma and Hideki Mizuuchi and Ken Okazaki and Tetsuro Ushio and Koji Murakami and Satoshi Hamai and Yukio Akasaki and Yasuharu Nakashima",
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T1 - Effects of tibial baseplate shape on rotational alignment in total knee arthroplasty

T2 - three-dimensional surgical simulation using osteoarthritis knees

AU - Ma, Yuan

AU - Mizuuchi, Hideki

AU - Okazaki, Ken

AU - Ushio, Tetsuro

AU - Murakami, Koji

AU - Hamai, Satoshi

AU - Akasaki, Yukio

AU - Nakashima, Yasuharu

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: Placement of tibial component is expected to fulfill both maximum surface coverage and recommended anterior–posterior (AP) alignment in total knee arthroplasty (TKA). The purpose of this study is to evaluate the effect of the tibial baseplate shape on AP axis. Materials and methods: Virtual surgery of TKA was performed with three-dimensional bone models reconstructed from 77 osteoarthritis varus knees. Two differently designed tibial baseplates, symmetrically and anatomically, were set to the cut surface under posterior slopes of 0°, 3°, and 7°. The AP axes were defined by connecting the geometrical center of the cut surface with the medial edge (axis MED) and medial 1/3 (axis 1/3MED) of patella tendon attachment. We evaluated the overhang rates as well as the most fitting AP axis which passes through the geometric center. Results: Overhang rates when aligned to axis MED were 12–25% for the symmetrical-type group and 13–22% for the anatomical-type group. Overhang rates when aligned to axis 1/3MED were 42–48% for the symmetrical-type group and 3–7% for the anatomical-type group. The most fitting AP axis of tibial baseplate was located 2.5° external to axis MED for the symmetrical-type group and around 3.3° internal to axis 1/3MED for the anatomical-type group. Conclusions: Symmetrically or anatomically designed tibial baseplates have their own favored AP axis and specific performance on coverage. When aligned to axis 1/3MED, anatomically designed tibial baseplates will effectively lower the mismatch rates compared to a symmetrically designed tibial baseplate. Orthopaedic surgeons are expected to place the tibial components to the cut surface during TKA with full understanding of the features between different baseplate designs, AP axes, and posterior slopes for an ideal tibial rotational position.

AB - Introduction: Placement of tibial component is expected to fulfill both maximum surface coverage and recommended anterior–posterior (AP) alignment in total knee arthroplasty (TKA). The purpose of this study is to evaluate the effect of the tibial baseplate shape on AP axis. Materials and methods: Virtual surgery of TKA was performed with three-dimensional bone models reconstructed from 77 osteoarthritis varus knees. Two differently designed tibial baseplates, symmetrically and anatomically, were set to the cut surface under posterior slopes of 0°, 3°, and 7°. The AP axes were defined by connecting the geometrical center of the cut surface with the medial edge (axis MED) and medial 1/3 (axis 1/3MED) of patella tendon attachment. We evaluated the overhang rates as well as the most fitting AP axis which passes through the geometric center. Results: Overhang rates when aligned to axis MED were 12–25% for the symmetrical-type group and 13–22% for the anatomical-type group. Overhang rates when aligned to axis 1/3MED were 42–48% for the symmetrical-type group and 3–7% for the anatomical-type group. The most fitting AP axis of tibial baseplate was located 2.5° external to axis MED for the symmetrical-type group and around 3.3° internal to axis 1/3MED for the anatomical-type group. Conclusions: Symmetrically or anatomically designed tibial baseplates have their own favored AP axis and specific performance on coverage. When aligned to axis 1/3MED, anatomically designed tibial baseplates will effectively lower the mismatch rates compared to a symmetrically designed tibial baseplate. Orthopaedic surgeons are expected to place the tibial components to the cut surface during TKA with full understanding of the features between different baseplate designs, AP axes, and posterior slopes for an ideal tibial rotational position.

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