Tibial component alignment and risk of loosening in unicompartmental knee arthroplasty: a radiographic and radiostereometric study

P. Barbadoro, A. Ensini, A. Leardini, M. d’Amato, A. Feliciangeli, A. Timoncini, F. Amadei, C. Belvedere, S. Giannini

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose: Unicompartmental knee arthroplasty (UKA) has shown a higher rate of revision compared with total knee arthroplasty. The success of UKA depends on prosthesis component alignment, fixation and soft tissue integrity. The tibial cut is the crucial surgical step. The hypothesis of the present study is that tibial component malalignment is correlated with its risk of loosening in UKA.

Methods: This study was performed in twenty-three patients undergoing primary cemented unicompartmental knee arthroplasties. Translations and rotations of the tibial component and the maximum total point motion (MTPM) were measured using radiostereometric analysis at 3, 6, 12 and 24 months. Standard radiological evaluations were also performed immediately before and after surgery. Varus/valgus and posterior slope of the tibial component and tibial–femoral axes were correlated with radiostereometric micro-motion. A survival analysis was also performed at an average of 5.9 years by contacting patients by phone.

Results: Varus alignment of the tibial component was significantly correlated with MTPM, anterior tibial sinking, varus rotation and anterior and medial translations from radiostereometry. The posterior slope of the tibial component was correlated with external rotation. The survival rate at an average of 5.9 years was 89 %. The two patients who underwent revision presented a tibial component varus angle of 10° for both.

Conclusions: There is correlation between varus orientation of the tibial component and MTPM from radiostereometry in unicompartmental knee arthroplasties. Particularly, a misalignment in varus larger than 5° could lead to risk of loosening the tibial component.

Level of evidence: Prognostic studies—retrospective study, Level II.

Original languageEnglish
Pages (from-to)3157-3162
Number of pages6
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume22
Issue number12
DOIs
Publication statusPublished - Nov 20 2014

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Knee Replacement Arthroplasties
Radiostereometric Analysis
Tissue Fixation
Survival Analysis
Prostheses and Implants
Survival Rate

Keywords

  • Maximum total point motion (MTPM)
  • Radiostereometry (RSA)
  • Tibial component alignment
  • Tibial component fixation
  • Unicompartmental knee arthroplasty (UKA)

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery
  • Medicine(all)

Cite this

Tibial component alignment and risk of loosening in unicompartmental knee arthroplasty : a radiographic and radiostereometric study. / Barbadoro, P.; Ensini, A.; Leardini, A.; d’Amato, M.; Feliciangeli, A.; Timoncini, A.; Amadei, F.; Belvedere, C.; Giannini, S.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 22, No. 12, 20.11.2014, p. 3157-3162.

Research output: Contribution to journalArticle

Barbadoro, P. ; Ensini, A. ; Leardini, A. ; d’Amato, M. ; Feliciangeli, A. ; Timoncini, A. ; Amadei, F. ; Belvedere, C. ; Giannini, S. / Tibial component alignment and risk of loosening in unicompartmental knee arthroplasty : a radiographic and radiostereometric study. In: Knee Surgery, Sports Traumatology, Arthroscopy. 2014 ; Vol. 22, No. 12. pp. 3157-3162.
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T1 - Tibial component alignment and risk of loosening in unicompartmental knee arthroplasty

T2 - a radiographic and radiostereometric study

AU - Barbadoro, P.

AU - Ensini, A.

AU - Leardini, A.

AU - d’Amato, M.

AU - Feliciangeli, A.

AU - Timoncini, A.

AU - Amadei, F.

AU - Belvedere, C.

AU - Giannini, S.

PY - 2014/11/20

Y1 - 2014/11/20

N2 - Purpose: Unicompartmental knee arthroplasty (UKA) has shown a higher rate of revision compared with total knee arthroplasty. The success of UKA depends on prosthesis component alignment, fixation and soft tissue integrity. The tibial cut is the crucial surgical step. The hypothesis of the present study is that tibial component malalignment is correlated with its risk of loosening in UKA.Methods: This study was performed in twenty-three patients undergoing primary cemented unicompartmental knee arthroplasties. Translations and rotations of the tibial component and the maximum total point motion (MTPM) were measured using radiostereometric analysis at 3, 6, 12 and 24 months. Standard radiological evaluations were also performed immediately before and after surgery. Varus/valgus and posterior slope of the tibial component and tibial–femoral axes were correlated with radiostereometric micro-motion. A survival analysis was also performed at an average of 5.9 years by contacting patients by phone.Results: Varus alignment of the tibial component was significantly correlated with MTPM, anterior tibial sinking, varus rotation and anterior and medial translations from radiostereometry. The posterior slope of the tibial component was correlated with external rotation. The survival rate at an average of 5.9 years was 89 %. The two patients who underwent revision presented a tibial component varus angle of 10° for both.Conclusions: There is correlation between varus orientation of the tibial component and MTPM from radiostereometry in unicompartmental knee arthroplasties. Particularly, a misalignment in varus larger than 5° could lead to risk of loosening the tibial component.Level of evidence: Prognostic studies—retrospective study, Level II.

AB - Purpose: Unicompartmental knee arthroplasty (UKA) has shown a higher rate of revision compared with total knee arthroplasty. The success of UKA depends on prosthesis component alignment, fixation and soft tissue integrity. The tibial cut is the crucial surgical step. The hypothesis of the present study is that tibial component malalignment is correlated with its risk of loosening in UKA.Methods: This study was performed in twenty-three patients undergoing primary cemented unicompartmental knee arthroplasties. Translations and rotations of the tibial component and the maximum total point motion (MTPM) were measured using radiostereometric analysis at 3, 6, 12 and 24 months. Standard radiological evaluations were also performed immediately before and after surgery. Varus/valgus and posterior slope of the tibial component and tibial–femoral axes were correlated with radiostereometric micro-motion. A survival analysis was also performed at an average of 5.9 years by contacting patients by phone.Results: Varus alignment of the tibial component was significantly correlated with MTPM, anterior tibial sinking, varus rotation and anterior and medial translations from radiostereometry. The posterior slope of the tibial component was correlated with external rotation. The survival rate at an average of 5.9 years was 89 %. The two patients who underwent revision presented a tibial component varus angle of 10° for both.Conclusions: There is correlation between varus orientation of the tibial component and MTPM from radiostereometry in unicompartmental knee arthroplasties. Particularly, a misalignment in varus larger than 5° could lead to risk of loosening the tibial component.Level of evidence: Prognostic studies—retrospective study, Level II.

KW - Maximum total point motion (MTPM)

KW - Radiostereometry (RSA)

KW - Tibial component alignment

KW - Tibial component fixation

KW - Unicompartmental knee arthroplasty (UKA)

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