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Anatomical tibial component is related to more medial tibial stress shielding after total knee arthroplasty in Korean patients

Authors
 Byung Woo Cho  ;  Hyuck Min Kwon  ;  Yong Jae Hong  ;  Kwan Kyu Park  ;  Ick Hwan Yang  ;  Woo-Suk Lee 
Citation
 KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol.29(3) : 710-717, 2021-03 
Journal Title
 KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 
ISSN
 0942-2056 
Issue Date
2021-03
Keywords
Anatomical tibial component ; Asymmetric tibial base plate ; Medial tibial bone loss ; Medialized keel ; Stress shielding ; Total knee arthroplasty
Abstract
Purpose: This study aimed to investigate stress shielding of anatomical tibial components (ATCs) in comparison to conventional symmetric tibial components (STCs) in Korean patients which may be related to medial tibial bone loss. Method: 78 knees in 59 patients with ATCs (Persona™) and 74 knees in 58 patients with STCs (NexGen LPS-Flex™) were retrospectively reviewed. Radiographic parameters and clinical outcomes in both groups were compared. Logistic regression analysis was performed to identify risk factors for medial tibial bone loss. Results: Medial tibial bone loss was significantly greater in the ATC group (1.6 ± 1.3 mm) than in the STC group (0.4 ± 0.8 mm) (p < 0.001). The ATC group showed a shorter distance between the distal metal tip and anteromedial cortex and higher invading into the sclerotic bone lesion (ISBL) than the STC group (p = 0.034 and p = 0.044, respectively). Multiple logistic regression analysis suggested ATC, a shorter distance to the anteromedial cortex, and the presence of ISBL as risk factors for medial tibial bone loss. The odds ratios of medial tibial bone loss according to type of prosthesis, distance to anteromedial cortex, and presence of ISBL were 6.25 (range 2.86-13.63, p < 0.001), 0.69 (range 0.51-0.93, p = 0.015), and 3.79 (range 1.56-9.21, p = 0.003), respectively. Notwithstanding, there was no difference in clinical outcomes between the two groups. Conclusion: In Korean patients, ATCs potentially causes greater medial tibial bone loss due to stress shielding than STCs. The design, however, does not yet appear to affect clinical outcomes at mid-term follow-up. Level of evidence: Retrospective cohort study, level III.
Full Text
https://link.springer.com/article/10.1007%2Fs00167-020-05869-x
DOI
10.1007/s00167-020-05869-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Hyuck Min(권혁민) ORCID logo https://orcid.org/0000-0002-2924-280X
Park, Kwan Kyu(박관규) ORCID logo https://orcid.org/0000-0003-0514-3257
Yang, Ick Hwan(양익환)
Lee, Woo Suk(이우석) ORCID logo https://orcid.org/0000-0002-0798-1660
Cho, Byung Woo(조병우) ORCID logo https://orcid.org/0000-0002-7472-4103
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182358
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