The medial tibial joint line elevation over 5 mm restrained the improvement of knee extension angle in unicompartmental knee arthroplasty View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-11-09

AUTHORS

Koji Takayama, Kazunari Ishida, Hirotsugu Muratsu, Yuichi Kuroda, Masanori Tsubosaka, Shingo Hashimoto, Shinya Hayashi, Takehiko Matsushita, Takahiro Niikura, Ryosuke Kuroda, Tomoyuki Matsumoto

ABSTRACT

PurposeThe purpose of this study was to examine the relationship between medial tibial joint line elevation and the improvement of range of motion (ROM) in unicompartmental knee arthroplasty (UKA). The hypothesis was that limited elevation of tibial joint line will improve knee range of motion in UKA.MethodsForty-six consecutive medial UKAs were enrolled in this study. Medial tibial joint line elevation was defined as the polyethylene insert and tibial tray thickness minus the tibial osteotomy and sawblade thickness. Positive values indicated an elevation of the tibial joint line. A component gap between the femoral trial prosthesis and the medial tibial osteotomy surface was also examined. Joint loosening was also calculated based on the joint component gap minus insert and tibial tray thickness. The correlation of the medial tibial joint line elevation with joint looseness and postoperative range of motion were analyzed.ResultsThe mean medial tibial joint line elevation was 4.9 ± 1.1 mm. The medial tibial joint line elevation reduced the improvement of knee extension (R = − 0.43, p < 0.01). The medial tibial joint line elevation was also correlated with reduced loosening of the joint knee extension (R = − 0.42, p < 0.01). This, in turn, resulted in limited improvement of the knee extension angle. Moreover, joint line elevation under 5 mm significantly improved knee extension angle compared to joint line elevation over 5 mm.ConclusionsThe medial joint line elevation of the tibia in UKA reduced the improvement of knee extension angle, due to a reduced joint looseness at knee extension. A tibial joint line elevation greater than 5 mm in UKA should be avoided to prevent postoperative flexion contracture. For the clinical relevance, this study clarified that the medial joint line of the tibia is an important factor to prevent postoperative flexion contracture in UKA.Level of evidenceII. More... »

PAGES

1737-1742

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00167-017-4763-8

DOI

http://dx.doi.org/10.1007/s00167-017-4763-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1092616302

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29124288


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21 schema:description PurposeThe purpose of this study was to examine the relationship between medial tibial joint line elevation and the improvement of range of motion (ROM) in unicompartmental knee arthroplasty (UKA). The hypothesis was that limited elevation of tibial joint line will improve knee range of motion in UKA.MethodsForty-six consecutive medial UKAs were enrolled in this study. Medial tibial joint line elevation was defined as the polyethylene insert and tibial tray thickness minus the tibial osteotomy and sawblade thickness. Positive values indicated an elevation of the tibial joint line. A component gap between the femoral trial prosthesis and the medial tibial osteotomy surface was also examined. Joint loosening was also calculated based on the joint component gap minus insert and tibial tray thickness. The correlation of the medial tibial joint line elevation with joint looseness and postoperative range of motion were analyzed.ResultsThe mean medial tibial joint line elevation was 4.9 ± 1.1 mm. The medial tibial joint line elevation reduced the improvement of knee extension (R = − 0.43, p < 0.01). The medial tibial joint line elevation was also correlated with reduced loosening of the joint knee extension (R = − 0.42, p < 0.01). This, in turn, resulted in limited improvement of the knee extension angle. Moreover, joint line elevation under 5 mm significantly improved knee extension angle compared to joint line elevation over 5 mm.ConclusionsThe medial joint line elevation of the tibia in UKA reduced the improvement of knee extension angle, due to a reduced joint looseness at knee extension. A tibial joint line elevation greater than 5 mm in UKA should be avoided to prevent postoperative flexion contracture. For the clinical relevance, this study clarified that the medial joint line of the tibia is an important factor to prevent postoperative flexion contracture in UKA.Level of evidenceII.
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83 reduced loosening
84 relationship
85 relevance
86 study
87 surface
88 thickness
89 tibia
90 tibial joint line
91 tibial joint line elevation
92 tibial osteotomy
93 tibial osteotomy surface
94 tibial tray thickness
95 tray thickness
96 trial prosthesis
97 turn
98 unicompartmental knee arthroplasty
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