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Difference between medial and lateral tibia plateau in the coronal plane: importance of preoperative evaluation for medial unicompartmental knee arthroplasty

BACKGROUND: Setting bone cutting levels for different joint line orientations of the medial and lateral tibia plateaus in individual patients is not clear. We aimed to evaluate the difference between joint line orientation of the medial and lateral tibia plateaus relative to the horizontal line of m...

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Autores principales: Alruwaili, Sager h, Park, Kwan Kyu, Yang, Ick Hwan, Lee, Woo-Suk, Cho, Byung-Woo, Kwon, Hyuck Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994383/
https://www.ncbi.nlm.nih.gov/pubmed/35397513
http://dx.doi.org/10.1186/s12891-022-05298-6
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author Alruwaili, Sager h
Park, Kwan Kyu
Yang, Ick Hwan
Lee, Woo-Suk
Cho, Byung-Woo
Kwon, Hyuck Min
author_facet Alruwaili, Sager h
Park, Kwan Kyu
Yang, Ick Hwan
Lee, Woo-Suk
Cho, Byung-Woo
Kwon, Hyuck Min
author_sort Alruwaili, Sager h
collection PubMed
description BACKGROUND: Setting bone cutting levels for different joint line orientations of the medial and lateral tibia plateaus in individual patients is not clear. We aimed to evaluate the difference between joint line orientation of the medial and lateral tibia plateaus relative to the horizontal line of mechanical axis of tibia as tibial plateau difference (TPD) for an optimal tibial bone cut in medial unicompartmental knee arthroplasty (UKA) and determine which factors could influence TPD. We aimed to investigate the effect of preoperative TPD on polyethylene liner size in medial UKA. METHODS: TPD in the coronal plane were measured in 181 female patients (181 knees). To determine the morphology of proximal tibia according to the severity of osteoarthritis, the patients were classified into three groups based on diagnosis and treatment: 80 who underwent robot-assisted medial UKA, 45 who underwent total knee arthroplasty (TKA), and 56 with early-stage osteoarthritis (OA) who had conservative management. Also, we divided the medial UKA group into two groups according to TPD (greater than or less than 5 mm) and compared polyethylene liner sizes. RESULTS: No significant difference was observed in TPD (p = 0.662), difference between the medial and lateral femoral condyle levels (p = 0.54), medial proximal tibial angle (p = 0.169), or posterior tibial slope (p = 0.466) among the three groups. Increased TPD was significantly associated with increased mechanical femorotibial angle(mFTA) (p < 0.01). The medial UKA group was divided into two groups according to TPD greater or less than 5 mm. Thicker polyethylene liners were used for groups with TPD greater than 5 mm (8.5 ± 0.7 mm versus 8.2 ± 0.3 mm, p = 0.01). Additionally, the proportion of patients using the thinnest polyethylene (8 mm) in each TPD group (greater or less than 5 mm) was higher in patients with TPD less than 5 mm (82.4% versus 58.7%, p = 0.038). CONCLUSIONS: Preoperative measurement of TPD is important to help surgeons predict the most appropriate bone cutting level in the coronal plane in primary medial UKA. Tibial bone resection would be likely to be thicker than needed in patients with increased TPD in medial UKA.
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spelling pubmed-89943832022-04-10 Difference between medial and lateral tibia plateau in the coronal plane: importance of preoperative evaluation for medial unicompartmental knee arthroplasty Alruwaili, Sager h Park, Kwan Kyu Yang, Ick Hwan Lee, Woo-Suk Cho, Byung-Woo Kwon, Hyuck Min BMC Musculoskelet Disord Research BACKGROUND: Setting bone cutting levels for different joint line orientations of the medial and lateral tibia plateaus in individual patients is not clear. We aimed to evaluate the difference between joint line orientation of the medial and lateral tibia plateaus relative to the horizontal line of mechanical axis of tibia as tibial plateau difference (TPD) for an optimal tibial bone cut in medial unicompartmental knee arthroplasty (UKA) and determine which factors could influence TPD. We aimed to investigate the effect of preoperative TPD on polyethylene liner size in medial UKA. METHODS: TPD in the coronal plane were measured in 181 female patients (181 knees). To determine the morphology of proximal tibia according to the severity of osteoarthritis, the patients were classified into three groups based on diagnosis and treatment: 80 who underwent robot-assisted medial UKA, 45 who underwent total knee arthroplasty (TKA), and 56 with early-stage osteoarthritis (OA) who had conservative management. Also, we divided the medial UKA group into two groups according to TPD (greater than or less than 5 mm) and compared polyethylene liner sizes. RESULTS: No significant difference was observed in TPD (p = 0.662), difference between the medial and lateral femoral condyle levels (p = 0.54), medial proximal tibial angle (p = 0.169), or posterior tibial slope (p = 0.466) among the three groups. Increased TPD was significantly associated with increased mechanical femorotibial angle(mFTA) (p < 0.01). The medial UKA group was divided into two groups according to TPD greater or less than 5 mm. Thicker polyethylene liners were used for groups with TPD greater than 5 mm (8.5 ± 0.7 mm versus 8.2 ± 0.3 mm, p = 0.01). Additionally, the proportion of patients using the thinnest polyethylene (8 mm) in each TPD group (greater or less than 5 mm) was higher in patients with TPD less than 5 mm (82.4% versus 58.7%, p = 0.038). CONCLUSIONS: Preoperative measurement of TPD is important to help surgeons predict the most appropriate bone cutting level in the coronal plane in primary medial UKA. Tibial bone resection would be likely to be thicker than needed in patients with increased TPD in medial UKA. BioMed Central 2022-04-09 /pmc/articles/PMC8994383/ /pubmed/35397513 http://dx.doi.org/10.1186/s12891-022-05298-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Alruwaili, Sager h
Park, Kwan Kyu
Yang, Ick Hwan
Lee, Woo-Suk
Cho, Byung-Woo
Kwon, Hyuck Min
Difference between medial and lateral tibia plateau in the coronal plane: importance of preoperative evaluation for medial unicompartmental knee arthroplasty
title Difference between medial and lateral tibia plateau in the coronal plane: importance of preoperative evaluation for medial unicompartmental knee arthroplasty
title_full Difference between medial and lateral tibia plateau in the coronal plane: importance of preoperative evaluation for medial unicompartmental knee arthroplasty
title_fullStr Difference between medial and lateral tibia plateau in the coronal plane: importance of preoperative evaluation for medial unicompartmental knee arthroplasty
title_full_unstemmed Difference between medial and lateral tibia plateau in the coronal plane: importance of preoperative evaluation for medial unicompartmental knee arthroplasty
title_short Difference between medial and lateral tibia plateau in the coronal plane: importance of preoperative evaluation for medial unicompartmental knee arthroplasty
title_sort difference between medial and lateral tibia plateau in the coronal plane: importance of preoperative evaluation for medial unicompartmental knee arthroplasty
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994383/
https://www.ncbi.nlm.nih.gov/pubmed/35397513
http://dx.doi.org/10.1186/s12891-022-05298-6
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