Patient - implant dimension mismatch in total knee arthroplasty: Is it worth worrying? An Indian scenario
Background: The correct sizing of the components in both anteroposterior and mediolateral (ML) dimensions is crucial for the success of a total knee arthroplasty (TKA). The size of the implants selected is based on the intraoperative measurements. The currently used TKA implants available to us are...
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Published in | Indian journal of orthopaedics Vol. 50; no. 5; pp. 512 - 517 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
New Delhi
Springer India
01.09.2016
Wolters Kluwer - Medknow Publications Medknow Publications and Media Pvt. Ltd Medknow Publications & Media Pvt. Ltd Medknow Publications & Media Pvt Ltd |
Subjects | |
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Abstract | Background:
The correct sizing of the components in both anteroposterior and mediolateral (ML) dimensions is crucial for the success of a total knee arthroplasty (TKA). The size of the implants selected is based on the intraoperative measurements. The currently used TKA implants available to us are based on morphometric measurements obtained from a Western/Caucasian population. Hence, the risk of component ML mismatch is more common in Asian sub-population, as they are of a smaller built and stature. This study aims to look into the following aspects - magnitude of the ML mismatch between the femoral component and the patient’s anatomical dimension, evaluation of gender variations in distal femur dimensions, and gender-wise and implant-wise correlation of ML mismatch.
Materials and Methods:
Intraoperatively, the distal femoral dimensions were measured using sterile calipers after removing the osteophytes and compared with the ML dimension of the implant used. ML mismatch length thus obtained is correlated with the various parameters.
Results:
Males showed larger distal femoral dimensions when compared to females. Males had larger ML mismatch. None of the implants used perfectly matched the patient’s anatomical dimensions. Patients with larger mismatch had lower scorings at 2 years postoperative followup.
Conclusion:
Implant manufacturers need to design more options of femoral implants for a better fit in our subset of patients. The exact magnitude of mismatch which can cause functional implications need to be made out. The mismatch being one of the important factors for the success of the surgery, we should focus more on this aspect. |
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AbstractList | Background:
The correct sizing of the components in both anteroposterior and mediolateral (ML) dimensions is crucial for the success of a total knee arthroplasty (TKA). The size of the implants selected is based on the intraoperative measurements. The currently used TKA implants available to us are based on morphometric measurements obtained from a Western/Caucasian population. Hence, the risk of component ML mismatch is more common in Asian sub-population, as they are of a smaller built and stature. This study aims to look into the following aspects - magnitude of the ML mismatch between the femoral component and the patient’s anatomical dimension, evaluation of gender variations in distal femur dimensions, and gender-wise and implant-wise correlation of ML mismatch.
Materials and Methods:
Intraoperatively, the distal femoral dimensions were measured using sterile calipers after removing the osteophytes and compared with the ML dimension of the implant used. ML mismatch length thus obtained is correlated with the various parameters.
Results:
Males showed larger distal femoral dimensions when compared to females. Males had larger ML mismatch. None of the implants used perfectly matched the patient’s anatomical dimensions. Patients with larger mismatch had lower scorings at 2 years postoperative followup.
Conclusion:
Implant manufacturers need to design more options of femoral implants for a better fit in our subset of patients. The exact magnitude of mismatch which can cause functional implications need to be made out. The mismatch being one of the important factors for the success of the surgery, we should focus more on this aspect. BACKGROUNDThe correct sizing of the components in both anteroposterior and mediolateral (ML) dimensions is crucial for the success of a total knee arthroplasty (TKA). The size of the implants selected is based on the intraoperative measurements. The currently used TKA implants available to us are based on morphometric measurements obtained from a Western/Caucasian population. Hence, the risk of component ML mismatch is more common in Asian sub-population, as they are of a smaller built and stature. This study aims to look into the following aspects agnitude of the ML mismatch between the femoral component and the patient's anatomical dimension, evaluation of gender variations in distal femur dimensions, and gender-wise and implant-wise correlation of ML mismatch. MATERIALS AND METHODSIntraoperatively, the distal femoral dimensions were measured using sterile calipers after removing the osteophytes and compared with the ML dimension of the implant used. ML mismatch length thus obtained is correlated with the various parameters. RESULTSMales showed larger distal femoral dimensions when compared to females. Males had larger ML mismatch. None of the implants used perfectly matched the patient's anatomical dimensions. Patients with larger mismatch had lower scorings at 2 years postoperative followup. CONCLUSIONImplant manufacturers need to design more options of femoral implants for a better fit in our subset of patients. The exact magnitude of mismatch which can cause functional implications need to be made out. The mismatch being one of the important factors for the success of the surgery, we should focus more on this aspect. Background: The correct sizing of the components in both anteroposterior and mediolateral (ML) dimensions is crucial for the success of a total knee arthroplasty (TKA). The size of the implants selected is based on the intraoperative measurements. The currently used TKA implants available to us are based on morphometric measurements obtained from a Western/Caucasian population. Hence, the risk of component ML mismatch is more common in Asian sub-population, as they are of a smaller built and stature. This study aims to look into the following aspects agnitude of the ML mismatch between the femoral component and the patient's anatomical dimension, evaluation of gender variations in distal femur dimensions, and gender-wise and implant-wise correlation of ML mismatch. Materials and Methods: Intraoperatively, the distal femoral dimensions were measured using sterile calipers after removing the osteophytes and compared with the ML dimension of the implant used. ML mismatch length thus obtained is correlated with the various parameters. Results: Males showed larger distal femoral dimensions when compared to females. Males had larger ML mismatch. None of the implants used perfectly matched the patient's anatomical dimensions. Patients with larger mismatch had lower scorings at 2 years postoperative followup. Conclusion: Implant manufacturers need to design more options of femoral implants for a better fit in our subset of patients. The exact magnitude of mismatch which can cause functional implications need to be made out. The mismatch being one of the important factors for the success of the surgery, we should focus more on this aspect. The correct sizing of the components in both anteroposterior and mediolateral (ML) dimensions is crucial for the success of a total knee arthroplasty (TKA). The size of the implants selected is based on the intraoperative measurements. The currently used TKA implants available to us are based on morphometric measurements obtained from a Western/Caucasian population. Hence, the risk of component ML mismatch is more common in Asian sub-population, as they are of a smaller built and stature. This study aims to look into the following aspects agnitude of the ML mismatch between the femoral component and the patient's anatomical dimension, evaluation of gender variations in distal femur dimensions, and gender-wise and implant-wise correlation of ML mismatch. Intraoperatively, the distal femoral dimensions were measured using sterile calipers after removing the osteophytes and compared with the ML dimension of the implant used. ML mismatch length thus obtained is correlated with the various parameters. Males showed larger distal femoral dimensions when compared to females. Males had larger ML mismatch. None of the implants used perfectly matched the patient's anatomical dimensions. Patients with larger mismatch had lower scorings at 2 years postoperative followup. Implant manufacturers need to design more options of femoral implants for a better fit in our subset of patients. The exact magnitude of mismatch which can cause functional implications need to be made out. The mismatch being one of the important factors for the success of the surgery, we should focus more on this aspect. Background: The correct sizing of the components in both anteroposterior and mediolateral (ML) dimensions is crucial for the success of a total knee arthroplasty (TKA). The size of the implants selected is based on the intraoperative measurements. The currently used TKA implants available to us are based on morphometric measurements obtained from a Western/Caucasian population. Hence, the risk of component ML mismatch is more common in Asian sub-population, as they are of a smaller built and stature. This study aims to look into the following aspects agnitude of the ML mismatch between the femoral component and the patient′s anatomical dimension, evaluation of gender variations in distal femur dimensions, and gender-wise and implant-wise correlation of ML mismatch. Materials and Methods: Intraoperatively, the distal femoral dimensions were measured using sterile calipers after removing the osteophytes and compared with the ML dimension of the implant used. ML mismatch length thus obtained is correlated with the various parameters. Results: Males showed larger distal femoral dimensions when compared to females. Males had larger ML mismatch. None of the implants used perfectly matched the patient′s anatomical dimensions. Patients with larger mismatch had lower scorings at 2 years postoperative followup. Conclusion: Implant manufacturers need to design more options of femoral implants for a better fit in our subset of patients. The exact magnitude of mismatch which can cause functional implications need to be made out. The mismatch being one of the important factors for the success of the surgery, we should focus more on this aspect. |
Audience | Academic |
Author | Thilak, Jai George, Melvin J. |
AuthorAffiliation | Division of Arthroplasty and Sports Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India 1 Department of Orthopaedics, Amrita Institute of Medical Sciences, Kochi, Kerala, India |
AuthorAffiliation_xml | – name: 1 Department of Orthopaedics, Amrita Institute of Medical Sciences, Kochi, Kerala, India – name: Division of Arthroplasty and Sports Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India |
Author_xml | – sequence: 1 givenname: Jai surname: Thilak fullname: Thilak, Jai organization: Division of Arthroplasty and Sports Medicine, Amrita Institute of Medical Sciences – sequence: 2 givenname: Melvin J. surname: George fullname: George, Melvin J. email: johnirimpenz@yahoo.co.in organization: Department of Orthopaedics, Amrita Institute of Medical Sciences |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27746494$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.5115/acb.2010.43.3.252 10.2106/00004623-200300004-00015 10.1016/S0883-5403(00)91285-3 10.1016/j.knee.2009.12.005 10.1016/j.arth.2012.09.010 10.1007/s11999-008-0415-0 10.1007/s11999-012-2776-7 10.1302/0301-620X.94B5.28824 10.4236/ojra.2014.42012 10.1016/j.knee.2010.12.005 10.1016/j.knee.2005.05.002 10.1007/s11999-011-1782-5 10.3109/02713683.2014.922192 10.5704/MOJ.0911.005 10.1016/j.arth.2010.11.012 10.1007/s12178-014-9214-2 10.3928/01477447-20100625-19 10.3928/01477447-20110505-18 |
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Keywords | mediolateral mismatch total knee arthroplasty knee Distal femoral dimensions arthroplasty osteoarthritis femoral component Orthopaedic equipment replacement gender specific knee total knee arthroplasty MeSH terms: Orthopaedic equipment |
Language | English |
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Snippet | Background:
The correct sizing of the components in both anteroposterior and mediolateral (ML) dimensions is crucial for the success of a total knee... Background: The correct sizing of the components in both anteroposterior and mediolateral (ML) dimensions is crucial for the success of a total knee... The correct sizing of the components in both anteroposterior and mediolateral (ML) dimensions is crucial for the success of a total knee arthroplasty (TKA).... BACKGROUNDThe correct sizing of the components in both anteroposterior and mediolateral (ML) dimensions is crucial for the success of a total knee arthroplasty... |
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StartPage | 512 |
SubjectTerms | Conservative Orthopedics Knee replacement arthroplasty Medicine & Public Health Original Original Article Orthopedics Prostheses and implants Surgical Orthopedics |
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Title | Patient - implant dimension mismatch in total knee arthroplasty: Is it worth worrying? An Indian scenario |
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