Purpose Numerous studies demonstrated that prosthetic overhang and over-sizing cause pain and stiffness following total knee arthroplasty (TKA), but none considered volume changes within the joint capsule. This study was designed to inves- tigate differences in volumes of resected bone compared to implanted components in TKA, and to determine the incidence and factors related to ‘over-voluming’. Methods Three-dimensional reconstructions were created from 100 magnetic resonance imaging scans taken to design patient-specific instruments for TKA. The preoperative simulations were used to calculate the volume ratio (VR) by dividing volume of planned components by that of planned bone resections. Uni- and multi-variable linear regressions were performed to determine associations between ‘over-voluming’ (VR > 1.0) and gender, implant size and version (standard versus narrow), osteophytes, resection levels, external rotation of the femoral component, hip–knee–ankle (HKA) angle, mechanical lateral distal femoral angle (mLDFA), and mechanical medial proximal tibial angle (mMPTA). Results The overall implant/bone volume ratio was 0.91 ± 0.11 (range 0.63–1.16) with ‘over-voluming’ observed in 24 knees. Multi-variable regression confirmed over-voluming to be associated with lower mLDFA (OR 0.66; CI 0.45–0.93; p = 0.026) and extensive osteophytes (OR 0.14; CI 0.03–0.61; p = 0.014), but not HKA angle (OR 0.98; CI 0.76–1.26;
Knee Surgery, Sports Traumatology, Arthroscopy – Springer Journals
Published: Jun 2, 2018
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