The Change in Posterior Tibial Slope After Cementless Unicondylar Knee Arthroplasty

Veizi, Enejd; Fırat, Ahmet; Tecimel, Osman; Çepni, Şahin; Subaşı, İzzet Özay; Kılıçarslan, Kasım

doi:10.1016/j.arth.2020.12.041

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…Migration and subsidence regarding the tibial component of UKR has been the topic of many previous studies. The current literature supports the view that early postoperative subsidence, especially in cementless cases, is acceptable and may be inevitable in the first months [9,10]. This subsidence, which is both on the coronal and sagittal plane, tends to stop or diminish in the years following surgery, and in cementless cases, it is widely believed to be due to the bedding-in phenomenon.…”

Section: Discussionsupporting

confidence: 57%

“…Migration and subsidence with regard to the tibial component of UKR, whether cemented or cementless, is a well-known phenomenon that has been reported since the emergence of the first implant designs [6]. Often leading to premature revisions, especially in cemented cases [7,8], migration and subsidence patterns have been previously described in the literature [9,10]. The general consensus is that the component tends to subside more in the early postoperative months and then remain stable with good results in the long term.…”

Section: Introductionmentioning

confidence: 97%

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Plain Radiographs Can Safely Be Used to Measure and Follow Up on Tibial Component Alignment in Unicondylar Knee Replacement: A Correlation Study With CT Scans

Veizi¹,

Çay²,

Güven³

et al. 2021

Cureus

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Background and objectiveUnicondylar knee replacement (UKR) is one of the most frequently performed arthroplastic operations worldwide. Migration and subsidence regarding the tibial component of UKR is a well-known phenomenon. In this study, we aimed to analyze whether plain radiographs are a reliable means to measure the true coronal and sagittal alignment of the UKR's tibial component. MethodsPatients undergoing a UKR procedure at our center between December 2020 and March 2011 were eligible for this study. Inclusion criteria were as follows: the presence of well-aligned standard and reproducible anteroposterior and lateral X-rays taken one week before or after a low-radiation artifact-reduced CT scan. Sixty-six knees were included in the study. Coronal and sagittal alignment of the tibial component was measured in a standard manner by two observers on both X-rays and CT scans. A correlation analysis was performed, and the margin of error was established. ResultsIntra-observer reliability was high among the two observers whether for X-ray or CT scan measurements [intraclass correlation coefficient (ICC): >0.900]. On the other hand, coronal plane measurements had lower inter-observer ICC values on both X-rays and CT scans while reliability on the sagittal plane was higher. There was a high correlation between radiographic measurements on X-rays and CT scans on both planes. ConclusionEven though the measurements on plain radiographs were slightly different from the ones obtained from CT scans, the correlation between them was very strong. Caution should be exercised when measuring the coronal alignment of the tibial implant on X-rays since it is more frequently affected by rotational misalignment.

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Section: Discussionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 97%

Plain Radiographs Can Safely Be Used to Measure and Follow Up on Tibial Component Alignment in Unicondylar Knee Replacement: A Correlation Study With CT Scans

Veizi¹,

Çay²,

Güven³

et al. 2021

Cureus

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“…The radiographic evaluation revealed no significant changes in implant position within the FU (Table 3 ), which is in contrast to cementless unicondylar knee arthroplasty, where changes in the posterior tibial slope over time are reported [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

No component loosening of a cementless deep dish rotating platform knee at a 5-year follow-up

Stadler

Hofstätter

Luger

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Cemented fixation remains the gold standard in total knee arthroplasty. With an increasing number of younger patients undergoing total knee arthroplasty and a growing patient population demanding higher physical activity, a rising interest in discussion of cementless fixation is notable. The current scientific literature does not give a clear recommendation for or against uncemented total knee arthroplasty. The purpose of this study was the investigation of the 5-year clinical and radiographic outcomes of a cementless deep-dish rotating platform implant. Methods A total of 91 primary cementless total knee arthroplasties were included in this single-centre prospective observational study. The primary outcome was revision rate due to aseptic component loosening. Further outcome measures were assessment of the of the radiographic outcome as well as the clinical outcome based on Range of Motion and scores such as American Knee Society Score, Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score and European Quality of Life 5 Dimension 3 Level at a follow-up of 5 years. Results Mean age of the study population was 67.3 ± 6.6 years with 49.5% of the participants being female. Aseptic component loosening occurred in none of the patients. Implant survival with revision for any reason as endpoint was 97.8% (95% CI 100–96%) and 95.6% (95% CI 100–94%) with reoperation of any cause as endpoint. Radiolucent lines were detected in a total of eight cases (8.8%) and disappeared within the first year after surgery in five cases. Total Range of Motion improved significantly from 106° ± 15° preoperatively to 118° ± 10° at final FU (p < 0.001). All investigated scores improved significantly after total knee arthroplasty. Conclusion The results of this study reveal excellent mid-term performance of a cementless deep dish rotating platform total knee implant, with no component loosening, very low overall revision rate, only temporarily present radiolucent lines in a minority of patients and excellent clinical results. Therefore, cementless total knee arthroplasty is an appropriate treatment option for patients with severe osteoarthritis of the knee. Level of evidence Level II (prospective cohort study).

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“…Surgical treatments such as high tibial osteotomy (HTO) or unicondylar (UKA) and total (TKA) knee arthroplasty can change the TS and have an impact on knee biomechanics [ 14 , 15 , 16 ]. Recent studies have even shown a relationship between the TS and injuries of the anterior cruciate ligament (ACL) [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Morphological Analysis of the Tibial Slope in 720 Adult Knee Joints

et al. 2022

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Background: The tibial slope (TS) defines the posterior inclination of the tibial plateau (TP). The “individual physiological” TS plays a crucial role in knee-joint stability and should be taken into account in knee-joint surgery. The aim of this study was to analyse the specific morphology of the TS for the medial (med) and lateral (lat) TP in relation to patient characteristics and the measurement method. Methods: In this retrospective study, MRI images of knee joints from 720 patients (mean age: 49.9 years [±17.14]) were analysed. The TS was assessed using two established methods according to Hudek (TSH) and Karimi (TSK) for the med and lat TP and gender/side specificity was analysed. Results: TSH for the med and lat TP showed significantly (p < 0.001) different values compared to TSK (TSKmed: 2.6° (±3.7), TSHmed: 4.8° (±3.5); TSKlat: 3.0° (±4.0), TSHlat: 5.2° (±3.9)). The angles of the lat TP were significantly higher than those of the med TP (TSK: p < 0.001; TSH: p = 0.002). Females showed a higher med and lat TS compared to males (p < 0.001). Conclusions: The measurement method has an influence on the values of the TS in knee-joint MRIs. The TS is significantly different for the med and lat TP regardless of the measurement method. There are gender-specific differences for the TS.

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The Change in Posterior Tibial Slope After Cementless Unicondylar Knee Arthroplasty

Cited by 8 publications

References 26 publications

Plain Radiographs Can Safely Be Used to Measure and Follow Up on Tibial Component Alignment in Unicondylar Knee Replacement: A Correlation Study With CT Scans

Plain Radiographs Can Safely Be Used to Measure and Follow Up on Tibial Component Alignment in Unicondylar Knee Replacement: A Correlation Study With CT Scans

No component loosening of a cementless deep dish rotating platform knee at a 5-year follow-up

Morphological Analysis of the Tibial Slope in 720 Adult Knee Joints

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