Tibial Stems in Revision Total Knee Arthroplasty: Is There an Anatomic Conflict?

Authors:
Mohamed S Gobba
Mohamed S Gobba
Houston Methodist Hospital
Houston | United States
Newton Chan
Newton Chan
Institute for Orthopedic Research and Education
Tampa | United States
Rikin Patel
Rikin Patel
School of Medicine
Baltimore | United States
Philip C Noble
Philip C Noble
Institute of Orthopedic Research and Education
United States
Stephen J Incavo
Stephen J Incavo
Houston Methodist Hospital
Houston | United States

J Arthroplasty 2015 Sep 3;30(9 Suppl):86-9. Epub 2015 Jun 3.

Houston Methodist Hospital, Houston, Texas.

Tibial stems are frequently used in revision total knee arthroplasty (TKA). We investigated the effect of tibial stems on final component alignment and tray position. Thirty 3D reconstructed cadaveric tibial models were classified according to canal bow angle. After virtual implantation of 120 mm and 200 mm stemmed tibial components, deviation from native mechanical axis was measured. Tibial alignment valgus malposition of up to three degrees occurred and most pronounced with 120 mm stems. Canal alignment using 200 mm stems deviated tray position medially and posteriorly. Mild to moderate valgus bowing of the tibial canal is not uncommon (57% in our series) possibly leading to valgus malalignment. Anatomic conflict between the tibial mechanical axis and intramedullary canal can exist, with alignment and tray placement implications.

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http://dx.doi.org/10.1016/j.arth.2014.12.039DOI Listing

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September 2015
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