Effects of different prosthetic instrumentations on tibial bone resection in total knee arthroplasty

Yufeng Lu,Yangquan Hao,Xuechao Yuan,Feng Qiao

doi:10.1038/s41598-021-86787-x

Abstract

Our aim was to assess the accuracy of the obtained posterior tibial slope (PTS) with a fixed angle cutting block. 247 TKAs in 213 patients were reviewed. We included 104 Legion Prosthesis, 76 U2 Knee Prosthesis, 46 NexGen LPS-Flex Prosthesis, and 21 Vanguard Knee System products. Preoperative and postoperative PTS were measured via expanded lateral tibia radiographs. For postoperative PTS, the Legion group had significantly smaller slopes than the U2 Knee group and Vanguard group. However, there was no significant difference between the Legion and NexGen groups, and no significant difference among the NexGen, U2 Knee, and Vanguard groups. Multiple linear regression showed that the different tibial lengths and preoperative PTS had statistically significant effects on postoperative PTS. However, there were weak correlations between the tibial length and PTS, and between preoperative and postoperative PTS. For TKA, although the PTS is not completely consistent with the angle of the cutting block, using conventional tibial bone resection technology with different tibial cutting instrumentations provided by various manufacturers in TKA can obtain safe PTS.

Highlights

Our aim was to assess the accuracy of the obtained posterior tibial slope (PTS) with a fixed angle cutting block. 247 total knee arthroplasty (TKA) in 213 patients were reviewed
There were no statistically significant differences among the groups with regards to the demographic characteristics of patients before surgery, except that the age of the U2 Knee group was greater than the other groups (Table 2)
There was no significant difference in postoperative PTS between the Legion and NexGen groups (P = 0.08), and no significant differences were found among the NexGen, U2 Knee, and Vanguard groups

Summary

Introduction

Our aim was to assess the accuracy of the obtained posterior tibial slope (PTS) with a fixed angle cutting block. 247 TKAs in 213 patients were reviewed. Our aim was to assess the accuracy of the obtained posterior tibial slope (PTS) with a fixed angle cutting block. For postoperative PTS, the Legion group had significantly smaller slopes than the U2 Knee group and Vanguard group. For TKA, the PTS is not completely consistent with the angle of the cutting block, using conventional tibial bone resection technology with different tibial cutting instrumentations provided by various manufacturers in TKA can obtain safe PTS. The posterior tibial slope (PTS) relates to the postoperative range of motion[3] and function of the extensor mechanism[4]. For TKA tibial bone resection, various manufacturers provide cutting blocks with certain PTS. We aimed to assess the PTS after different tibial cutting instrumentations were employed for TKA. We hypothesized that the PTS achieved after osteotomy with different extramedullary guidance jigs are inconsistent with the fixed angle of the cutting blocks

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Conclusion