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Erschienen in: Die Orthopädie 12/2022

20.09.2022 | Originalien

Antero-posterior axis of the tibia is a better landmark for tibial component rotation in Oxford medial unicompartmental knee arthroplasty

verfasst von: Orkhan Aliyev, MD, Muzaffer Ağır, MD, Aghamazahir Aghazada, MD, Dilek Hacer Çeşme, MD, Deniz Kara, MD, Ali Toprak, PhD, İbrahim Tuncay, MD, Fatih Yıldız, MD, FEBOT

Erschienen in: Die Orthopädie | Ausgabe 12/2022

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Abstract

Background

This retrospective study compares tibial component rotations and radiological and functional outcomes in patients who underwent Oxford medial unicompartmental knee arthroplasty (UKA), using the antero-posterior (AP) tibia axis or anterior superior iliac spine (ASIS) as the landmarks for the direction of the vertical cut.

Methods

A total of 86 patients, who underwent Oxford medial UKA were divided into 2 groups, each consisting of 43 patients, according to the use of AP axis (group I) or ASIS (group II) as landmarks for the rotation of vertical tibial cut and compared for the radiological and functional outcomes. Tibial component rotations (α-angle), involvement of the posterior cruciate ligament (PCL) fossa, and instant bearing position (IBP) were measured on computed tomography (CT) images. Functional outcomes were evaluated using Oxford knee score (OKS) and Knee Society score (KSS).

Result

The median α‑angle was significantly smaller in group I than group II (2.5°, range −4–5.5° vs. −6°, range −13–0.5°, p < 0.001). The rates of PCL fossa involvements were 14 (32.6%) and 17 (39.5%, p = 0.7). The median flexion angle of the femoral component (7° vs. 10.5°) and posterior tibial slope (6° vs. 8°) were significantly lower in group I than group II (p = 0.001). All other radiological parameters, preoperative and final OKS and KSS were statistically similar in both groups.

Conclusion

Taking the AP tibial axis as a landmark for vertical tibial cut rotation provides more neutral tibial component rotation in Oxford medial UKA compared to ASIS; however, this difference may not influence the clinical outcomes.
Literatur
1.
Zurück zum Zitat Akagi M, Oh M, Nonaka T, Tsujimoto H, Asano T, Hamanishi C (2004) An anteroposterior axis of the tibia for total knee arthroplasty. Clin Orthop Relat Res 420:213–219CrossRef Akagi M, Oh M, Nonaka T, Tsujimoto H, Asano T, Hamanishi C (2004) An anteroposterior axis of the tibia for total knee arthroplasty. Clin Orthop Relat Res 420:213–219CrossRef
2.
Zurück zum Zitat Barbadoro P, Ensini A, Leardini A et al (2014) Tibial component alignment and risk of loosening in unicompartmental knee arthroplasty: a radiographic and radiostereometric study. Knee Surg Sports Traumatol Arthrosc 22(12):3157–3162CrossRefPubMed Barbadoro P, Ensini A, Leardini A et al (2014) Tibial component alignment and risk of loosening in unicompartmental knee arthroplasty: a radiographic and radiostereometric study. Knee Surg Sports Traumatol Arthrosc 22(12):3157–3162CrossRefPubMed
3.
Zurück zum Zitat Berger RA, Della Valle CJ (2010) Unicompartmental knee arthroplasty: indications, techniques, and results. Instr Course Lect 59:47–56PubMed Berger RA, Della Valle CJ (2010) Unicompartmental knee arthroplasty: indications, techniques, and results. Instr Course Lect 59:47–56PubMed
4.
Zurück zum Zitat Clarius M, Haas D, Aldinger PR, Jaeger S, Jakubowitz E, Seeger JB (2010) Periprosthetic tibial fractures in unicompartmental knee arthroplasty as a function of extended sagittal saw cuts: an experimental study. Knee 17(1):57–60CrossRefPubMed Clarius M, Haas D, Aldinger PR, Jaeger S, Jakubowitz E, Seeger JB (2010) Periprosthetic tibial fractures in unicompartmental knee arthroplasty as a function of extended sagittal saw cuts: an experimental study. Knee 17(1):57–60CrossRefPubMed
5.
Zurück zum Zitat Emerson RH Jr., Hansborough T, Reitman RD, Rosenfeldt W, Higgins LL (2002) Comparison of a mobile with a fixed-bearing unicompartmental knee implant. Clin Orthop Relat Res 404:62–70CrossRef Emerson RH Jr., Hansborough T, Reitman RD, Rosenfeldt W, Higgins LL (2002) Comparison of a mobile with a fixed-bearing unicompartmental knee implant. Clin Orthop Relat Res 404:62–70CrossRef
6.
Zurück zum Zitat Iriberri I, Aragon JF (2014) Alignment of the tibial component of the unicompartmental knee arthroplasty, assessed in the axial view by CT scan: does it influence the outcome? Knee 21(6):1269–1274CrossRefPubMed Iriberri I, Aragon JF (2014) Alignment of the tibial component of the unicompartmental knee arthroplasty, assessed in the axial view by CT scan: does it influence the outcome? Knee 21(6):1269–1274CrossRefPubMed
7.
Zurück zum Zitat Kamenaga T, Hiranaka T, Hida Y, Fujishiro T, Okamoto K (2019) Rotational position of the tibial component can decrease bony coverage of the tibial component in Oxford mobile-bearing unicompartmental knee arthroplasty. Knee 26(2):459–465CrossRefPubMed Kamenaga T, Hiranaka T, Hida Y, Fujishiro T, Okamoto K (2019) Rotational position of the tibial component can decrease bony coverage of the tibial component in Oxford mobile-bearing unicompartmental knee arthroplasty. Knee 26(2):459–465CrossRefPubMed
8.
Zurück zum Zitat Kamenaga T, Hiranaka T, Kikuchi K, Hida Y, Fujishiro T, Okamoto K (2018) Influence of tibial component rotation on short-term clinical outcomes in Oxford mobile-bearing unicompartmental knee arthroplasty. Knee 25(6):1222–1230CrossRefPubMed Kamenaga T, Hiranaka T, Kikuchi K, Hida Y, Fujishiro T, Okamoto K (2018) Influence of tibial component rotation on short-term clinical outcomes in Oxford mobile-bearing unicompartmental knee arthroplasty. Knee 25(6):1222–1230CrossRefPubMed
9.
Zurück zum Zitat Kamenaga T, Hiranaka T, Takayama K, Tsubosaka M, Kuroda R, Matsumoto T (2019) Adequate positioning of the tibial component is key to avoiding bearing impingement in oxford unicompartmental knee arthroplasty. J Arthroplasty 34(11):2606–2613CrossRefPubMed Kamenaga T, Hiranaka T, Takayama K, Tsubosaka M, Kuroda R, Matsumoto T (2019) Adequate positioning of the tibial component is key to avoiding bearing impingement in oxford unicompartmental knee arthroplasty. J Arthroplasty 34(11):2606–2613CrossRefPubMed
10.
Zurück zum Zitat Kawahara S, Matsuda S, Okazaki K, Tashiro Y, Iwamoto Y (2012) Is the medial wall of the intercondylar notch useful for tibial rotational reference in unicompartmental knee arthroplasty? Clin Orthop Relat Res 470(4):1177–1184CrossRefPubMed Kawahara S, Matsuda S, Okazaki K, Tashiro Y, Iwamoto Y (2012) Is the medial wall of the intercondylar notch useful for tibial rotational reference in unicompartmental knee arthroplasty? Clin Orthop Relat Res 470(4):1177–1184CrossRefPubMed
11.
Zurück zum Zitat Kendrick BJ, Simpson DJ, Kaptein BL et al (2011) Polyethylene wear of mobile-bearing unicompartmental knee replacement at 20 years. J Bone Joint Surg Br 93(4):470–475CrossRefPubMed Kendrick BJ, Simpson DJ, Kaptein BL et al (2011) Polyethylene wear of mobile-bearing unicompartmental knee replacement at 20 years. J Bone Joint Surg Br 93(4):470–475CrossRefPubMed
12.
Zurück zum Zitat Khanna G, Levy BA (2007) Oxford unicompartmental knee replacement: literature review. Orthopedics 30(5):11–14PubMed Khanna G, Levy BA (2007) Oxford unicompartmental knee replacement: literature review. Orthopedics 30(5):11–14PubMed
13.
Zurück zum Zitat Kristensen PW, Holm HA, Varnum C (2013) Up to 10-year follow-up of the Oxford medial partial knee arthroplasty—695 cases from a single institution. J Arthroplasty 28(9):195–198CrossRefPubMed Kristensen PW, Holm HA, Varnum C (2013) Up to 10-year follow-up of the Oxford medial partial knee arthroplasty—695 cases from a single institution. J Arthroplasty 28(9):195–198CrossRefPubMed
14.
Zurück zum Zitat Lee SY, Bae JH, Kim JG et al (2014) The influence of surgical factors on dislocation of the meniscal bearing after Oxford medial unicompartmental knee replacement: a case-control study. Bone Joint J 96(7):914–922CrossRefPubMed Lee SY, Bae JH, Kim JG et al (2014) The influence of surgical factors on dislocation of the meniscal bearing after Oxford medial unicompartmental knee replacement: a case-control study. Bone Joint J 96(7):914–922CrossRefPubMed
15.
Zurück zum Zitat Lee SY, Chay S, Lim HC, Bae JH (2017) Tibial component rotation during the unicompartmental knee arthroplasty: is the anterior superior iliac spine an appropriate landmark? Knee Surg Sports Traumatol Arthrosc 25(12):3723–3732CrossRefPubMed Lee SY, Chay S, Lim HC, Bae JH (2017) Tibial component rotation during the unicompartmental knee arthroplasty: is the anterior superior iliac spine an appropriate landmark? Knee Surg Sports Traumatol Arthrosc 25(12):3723–3732CrossRefPubMed
16.
Zurück zum Zitat Lee YS, Yun JY, Lee BK (2014) Tibial component coverage based on bone mineral density of the cut tibial surface during unicompartmental knee arthroplasty: clinical relevance of the prevention of tibial component subsidence. Arch Orthop Trauma Surg 134(1):85–89CrossRefPubMed Lee YS, Yun JY, Lee BK (2014) Tibial component coverage based on bone mineral density of the cut tibial surface during unicompartmental knee arthroplasty: clinical relevance of the prevention of tibial component subsidence. Arch Orthop Trauma Surg 134(1):85–89CrossRefPubMed
17.
Zurück zum Zitat Liow MH, Tsai TY, Dimitriou D, Li G, Kwon YM (2016) Does 3‑dimensional in vivo component rotation affect clinical outcomes in unicompartmental knee arthroplasty? J Arthroplasty 31(10):2167–2172CrossRefPubMed Liow MH, Tsai TY, Dimitriou D, Li G, Kwon YM (2016) Does 3‑dimensional in vivo component rotation affect clinical outcomes in unicompartmental knee arthroplasty? J Arthroplasty 31(10):2167–2172CrossRefPubMed
18.
Zurück zum Zitat Murray DW, Goodfellow JW, O’Connor JJ (1998) The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br 80(6):983–989CrossRefPubMed Murray DW, Goodfellow JW, O’Connor JJ (1998) The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br 80(6):983–989CrossRefPubMed
19.
Zurück zum Zitat Nicoll D, Rowley DI (2010) Internal rotational error of the tibial component is a major cause of pain after total knee replacement. J Bone Joint Surg Br 92(9):1238–1244CrossRefPubMed Nicoll D, Rowley DI (2010) Internal rotational error of the tibial component is a major cause of pain after total knee replacement. J Bone Joint Surg Br 92(9):1238–1244CrossRefPubMed
20.
Zurück zum Zitat Pandit H, Jenkins C, Gill HS, Barker K, Dodd CA, Murray DW (2011) Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases. J Bone Joint Surg Br 93(2):198–204CrossRefPubMed Pandit H, Jenkins C, Gill HS, Barker K, Dodd CA, Murray DW (2011) Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases. J Bone Joint Surg Br 93(2):198–204CrossRefPubMed
21.
Zurück zum Zitat Peersman G, Stuyts B, Vandenlangenbergh T, Cartier P, Fennema P (2015) Fixed- versus mobile-bearing UKA: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 23(11):3296–3305CrossRefPubMed Peersman G, Stuyts B, Vandenlangenbergh T, Cartier P, Fennema P (2015) Fixed- versus mobile-bearing UKA: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 23(11):3296–3305CrossRefPubMed
22.
Zurück zum Zitat Price AJ, Webb J, Topf H, Dodd CA, Goodfellow JW, Murray DW (2001) Rapid recovery after oxford unicompartmental arthroplasty through a short incision. J Arthroplasty 16(8):970–976CrossRefPubMed Price AJ, Webb J, Topf H, Dodd CA, Goodfellow JW, Murray DW (2001) Rapid recovery after oxford unicompartmental arthroplasty through a short incision. J Arthroplasty 16(8):970–976CrossRefPubMed
23.
Zurück zum Zitat Robertsson O, Knutson K, Lewold S, Lidgren L (2001) The routine of surgical management reduces failure after unicompartmental knee arthroplasty. J Bone Joint Surg Br 83(1):45–49CrossRefPubMed Robertsson O, Knutson K, Lewold S, Lidgren L (2001) The routine of surgical management reduces failure after unicompartmental knee arthroplasty. J Bone Joint Surg Br 83(1):45–49CrossRefPubMed
24.
Zurück zum Zitat Scott RD (2010) Mobile- versus fixed-bearing unicompartmental knee arthroplasty. Instr Course Lect 59:57–60PubMed Scott RD (2010) Mobile- versus fixed-bearing unicompartmental knee arthroplasty. Instr Course Lect 59:57–60PubMed
25.
Zurück zum Zitat Servien E, Fary C, Lustig S et al (2011) Tibial component rotation assessment using CT scan in medial and lateral unicompartmental knee arthroplasty. Orthop Traumatol Surg Res 97(3):272–275CrossRefPubMed Servien E, Fary C, Lustig S et al (2011) Tibial component rotation assessment using CT scan in medial and lateral unicompartmental knee arthroplasty. Orthop Traumatol Surg Res 97(3):272–275CrossRefPubMed
26.
Zurück zum Zitat Sloper PJ, Hing CB, Donell ST, Glasgow MM (2003) Intra-operative tibial plateau fracture during unicompartmental knee replacement: a case report. Knee 10(4):367–369CrossRefPubMed Sloper PJ, Hing CB, Donell ST, Glasgow MM (2003) Intra-operative tibial plateau fracture during unicompartmental knee replacement: a case report. Knee 10(4):367–369CrossRefPubMed
27.
Zurück zum Zitat Smith TO, Hing CB, Davies L, Donell ST (2009) Fixed versus mobile bearing unicompartmental knee replacement: a meta-analysis. Orthop Traumatol Surg Res 95(8):599–605CrossRefPubMed Smith TO, Hing CB, Davies L, Donell ST (2009) Fixed versus mobile bearing unicompartmental knee replacement: a meta-analysis. Orthop Traumatol Surg Res 95(8):599–605CrossRefPubMed
28.
Zurück zum Zitat Svärd UC, Price AJ (2001) Oxford medial unicompartmental knee arthroplasty. A survival analysis of an independent series. J Bone Joint Surg Br 83(2):191–194CrossRefPubMed Svärd UC, Price AJ (2001) Oxford medial unicompartmental knee arthroplasty. A survival analysis of an independent series. J Bone Joint Surg Br 83(2):191–194CrossRefPubMed
29.
Zurück zum Zitat Tsukamoto I, Akagi M, Mori S, Inoue S, Asada S, Matsumura F (2017) Anteroposterior rotational references of the tibia for medial unicompartmental knee arthroplasty in Japanese patients. J Arthroplasty 32(10):3169–3175CrossRefPubMed Tsukamoto I, Akagi M, Mori S, Inoue S, Asada S, Matsumura F (2017) Anteroposterior rotational references of the tibia for medial unicompartmental knee arthroplasty in Japanese patients. J Arthroplasty 32(10):3169–3175CrossRefPubMed
30.
Zurück zum Zitat White SH, Ludkowski PF, Goodfellow JW (1991) Anteromedial osteoarthritis of the knee. J Bone Joint Surg Br 73(4):582–586CrossRefPubMed White SH, Ludkowski PF, Goodfellow JW (1991) Anteromedial osteoarthritis of the knee. J Bone Joint Surg Br 73(4):582–586CrossRefPubMed
31.
Zurück zum Zitat Yoshida K, Tada M, Yoshida H, Takei S, Fukuoka S, Nakamura H (2013) Oxford phase 3 unicompartmental knee arthroplasty in Japan—clinical results in greater than one thousand cases over ten years. J Arthroplasty 28(9):168–171CrossRefPubMed Yoshida K, Tada M, Yoshida H, Takei S, Fukuoka S, Nakamura H (2013) Oxford phase 3 unicompartmental knee arthroplasty in Japan—clinical results in greater than one thousand cases over ten years. J Arthroplasty 28(9):168–171CrossRefPubMed
Metadaten
Titel
Antero-posterior axis of the tibia is a better landmark for tibial component rotation in Oxford medial unicompartmental knee arthroplasty
verfasst von
Orkhan Aliyev, MD
Muzaffer Ağır, MD
Aghamazahir Aghazada, MD
Dilek Hacer Çeşme, MD
Deniz Kara, MD
Ali Toprak, PhD
İbrahim Tuncay, MD
Fatih Yıldız, MD, FEBOT
Publikationsdatum
20.09.2022
Verlag
Springer Medizin
Erschienen in
Die Orthopädie / Ausgabe 12/2022
Print ISSN: 2731-7145
Elektronische ISSN: 2731-7153
DOI
https://doi.org/10.1007/s00132-022-04308-8

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