Tibia Vara Affects the Aspect Ratio of Tibial Resected Surface in Female Japanese Patients Undergoing TKA

Abstract

Tibia vara seen in Japanese patients reportedly influences the tibial component alignment when performing TKA. However, it is unclear whether tibia vara affects the component position and size selection. We therefore determined (1) the amount of medial tibial bow, (2) whether the tibia vara influences the aspect ratio of the tibial resected surface in aligning the tibial component with the tibial shaft axis, and (3) whether currently available tibial components fit the shapes of resected proximal tibias in terms of aspect ratio. We measured the tibia vara angle (TVA), proximal varus angle (PVA), and the mediolateral and middle AP dimensions of the resected surface using three-dimensional preoperative planning software in 90 knees of 74 female patients with varus osteoarthritis. We determined the correlations of the aspect ratio with TVA or PVA and compared the aspect ratios to those of five prosthesis designs. The mean TVA and PVA were 0.6° and 2.0°, respectively. The aspect ratio negatively correlated with both TVA and PVA (r = -0.53 and -0.55, respectively). The mean aspect ratio of the resected surface was 1.48 but gradually decreased with increasing AP dimension, whereas four of the five prostheses had a constant aspect ratio. The aspect ratio of resected tibial surface was inversely correlated to the degree of tibia vara, and currently available prosthesis designs do not fit well to the resected surface in terms of aspect ratio. The design of a tibial component with a smaller aspect ratio could be developed to obtain better bone coverage in Japanese patients.