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Knee Surg Sports Traumatol Arthrosc (2008) 16:11411145 DOI 10.1007/s00167-008-0620-0
KNEE
Lateral versus medial tibial plateau: morphometric analysis and adaptability with current tibial component design
E. Servien M. Saffarini S. Lustig S. Chomel Ph. Neyret
Received: 13 March 2008 / Accepted: 26 August 2008 / Published online: 9 September 2008 Springer-Verlag 2008
Abstract The purpose of this study was to analyze the in vivo dimensions of each tibial plateau for planning of unicompartmental knee arthroplasty (UKA), and to compare the morphometric data to the dimensions of nine current designs of UKA tibial components. Thirty-seven knees (31 females and 6 males) operated on with UKA were studied. All patients were examined postoperatively using computed tomography (CT). There were 18 lateral and 19 medial UKAs. On the CT scan, each operated tibial plateau was measured in the transverse plane at the resection level, just below the full polyethylene tibial component. We measured the length of the anteroposterior (AP) cut as well as the maximal mediolateral dimension of the resected plateau (perpendicular to the AP cut). We compared the measurements with nine current UKA systems: Accuris (Smith and Nephew), Advance (Wright Medical), HLS Uni Evolution (Tornier), Miller-Galante and ZUK (Zimmer), Oxford and Oxford a (Biomet),
Preservation (DePuy) and Unix (Stryker). There was good correlation between patient height and mediolateral dimension (r = 0.6), and between patient height and area of total tibial plateau (r = 0.7). The anteroposterior dimension was greater for the medial plateau (mean
50.8 mm, SD 3.3) than for the lateral plateau (mean47.2 mm, SD 3.3). This difference was statistically signicant (P = 0.0016). Some UKA implants are designed with an asymmetric femoral component, but none have an asymmetric tibial component. The present study suggests, however, that the shape of the medial tibial plateau differs from that of the lateral plateau. This difference can lead to mediolateral overhang for medial UKA, if the surgeon aims for optimal anteroposterior coverage.
Keywords Unicompartmental arthroplasty Design
Tibial component Tibial plateau Anatomy Knee
Introduction
Encouraging results have been published about unicompartmental knee arthroplasty (UKA), mostly in the medial compartment [4, 12]. UKA is a suitable procedure for elderly patients with unilateral knee osteoarthritis. However, indications are still not well dened, especially in the lateral compartment. The clinical outcome of UKA...