Abstract
Total knee arthroplasty (TKA) systems permit a degree of femoro-tibial component size mismatch. The effect of mismatched components on revision rates has not been evaluated in a large study. We reviewed 21,906 fixed-bearing PFC Sigma primary TKAs using the Australian Orthopaedic Association National Joint Replacement Registry, dividing patients into three groups: no femoro-tibial size mismatch, tibial component size>femoral component size, and femoral component>tibial component. Revision rates were higher when the femoral size was greater than the tibia, compared to both equal size (HR=1.20 (1.00, 1.45), P=0.047) and to tibial size greater than femoral (HR=1.60 (1.08, 2.37), P=0.019). Potential mechanisms to explain these findings include edge loading of polyethylene and increased tibial component stresses.
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