Bole Madhav, Teeter Matthew, Lanting Brent A, Howard James L
Division of Orthopaedic Surgery, London Health Sciences Centre, University Hospital, 339 Windermere Rd., London, Ontario N6A 5A5, Canada.
J Orthop. 2018 Mar 27;15(2):490-494. doi: 10.1016/j.jor.2018.03.025. eCollection 2018 Jun.
Bone defects of the proximal tibia following revision total knee arthroplasty (TKA) are challenging to manage, but must be addressed to provide lasting stability. This paper will categorize tibial bone defects into shape groups and correlate resulting groups to patient demographic data.
Retrospective analysis of four hundred and four patients post revision TKA between January 2005 and February 2014 was conducted. One hundred and eighteen met the inclusion criteria and were subcategorized by defect shape on their post-operative lateral and anterior-posterior (AP) radiographs. The subgroups of defect shape were subsequently analyzed with Fisher's exact test and one way ANOVA.
Trapezoidal shaped defects were the most common in both radiographic views, and the magnitude of the defect at the top joint line varied significantly amongst shape groups in both AP and lateral views. Trapezoid shaped defects were correlated with smaller defect top lengths in both views. There was no statistical correlation between defect shape BMI, TIV and reason for revision in lateral view. However, T-bilateral defect shapes were correlated with higher BMIs in AP view.
A volumetric classification system of tibial defects is necessary for preoperative planning in revision TKA. Common tibial bone defect shape groups were identified and analyzed in AP and lateral radiographs after revision TKA. Trapezoidal defects were the most common, and all other shapes followed a pattern of proximal enlargement tapering distally. Trapezoidal defects were smaller than other shapes and AP T-bilateral shaped defects were correlated with higher BMIs.
全膝关节置换术（TKA）翻修术后胫骨近端骨缺损的处理具有挑战性，但必须加以解决以提供持久的稳定性。本文将胫骨骨缺损按形状分组，并将所得分组与患者人口统计学数据相关联。
对2005年1月至2014年2月期间404例TKA翻修术后患者进行回顾性分析。118例符合纳入标准，并根据术后侧位和前后位（AP）X线片上的缺损形状进行亚分类。随后用Fisher精确检验和单因素方差分析对缺损形状亚组进行分析。
梯形缺损在两个X线片视图中最为常见，并且在AP视图和侧位视图中，不同形状组之间关节线上方缺损的大小差异显著。在两个视图中，梯形缺损都与较小的缺损顶部长度相关。在侧位视图中，缺损形状与体重指数（BMI）、总体积（TIV）和翻修原因之间无统计学相关性。然而，在AP视图中，双侧T形缺损与较高的BMI相关。
TKA翻修术前规划需要胫骨缺损的体积分类系统。在TKA翻修术后的AP和侧位X线片中识别并分析了常见的胫骨骨缺损形状组。梯形缺损最为常见，所有其他形状均呈现近端扩大、远端逐渐变细的模式。梯形缺损小于其他形状，且AP双侧T形缺损与较高的BMI相关。
