Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL.
J Arthroplasty. 2018 Aug;33(8):2640-2646. doi: 10.1016/j.arth.2018.03.052. Epub 2018 Mar 27.
Total knee arthroplasty (TKA) systems provide a set of incrementally sized tibial and femoral components intended to accommodate most knee parameters. However, the most commonly used systems in the United States were developed using data from Caucasian patients which might not lead to the best fit in non-Caucasians. Therefore, we wanted to evaluate whether these TKA systems proportionally match femoral and tibial measurements in Hispanics.
All lower extremity magnetic resonance imaging performed at our institution between January 2007 and October 2015 were screened. A total of 500 nonarthritic knees from the same number of Hispanic patients were included in this retrospective descriptive radiographic study. Intraoperative osseous TKA resections were simulated on magnetic resonance imaging. Linear regression analyses were used to contrast the mediolateral (ML) width/anteroposterior (AP) length of simulated resected femoral condyle and tibia with the ML/AP dimensions of components offered by 4 current TKA systems.
Simulated resected male femurs tended to be wider than most TKA system components for a given AP size, probably leading to component ML underhang. Altogether, systems studied accommodated most AP and ML measurements of female condyles. However, we identified subsets of Hispanic female patients with certain AP lengths and/or ML widths that particular knee systems could not accommodate. Resected male and female tibias tended to be slightly narrower than all TKA systems for a given AP size.
The results of our study provide valuable data concerning the unique morphology of the Hispanic knee. These data can assist surgeons in the selection of the most suitable TKA systems for these patients.
全膝关节置换术（TKA）系统提供了一套增量尺寸的胫骨和股骨组件，旨在适应大多数膝关节参数。然而，美国最常用的系统是使用来自白种人患者的数据开发的，这些数据在非白种人中可能无法达到最佳匹配。因此，我们想评估这些 TKA 系统是否能按比例匹配西班牙裔患者的股骨和胫骨测量值。
筛选了我们机构在 2007 年 1 月至 2015 年 10 月期间进行的所有下肢磁共振成像。这项回顾性描述性放射学研究共纳入了 500 例来自同一批西班牙裔患者的非关节炎膝关节。在磁共振成像上模拟了全膝关节置换术的术中骨切除。使用线性回归分析对比模拟切除的股骨髁的内外侧（ML）宽度/前后（AP）长度与 4 种当前 TKA 系统提供的组件的 ML/AP 尺寸。
模拟切除的男性股骨在给定的 AP 尺寸下往往比大多数 TKA 系统组件更宽，可能导致组件 ML 悬空。总的来说，所研究的系统可以适应大多数女性髁的 AP 和 ML 测量值。然而，我们发现了某些特定的 AP 长度和/或 ML 宽度的西班牙裔女性患者亚组，这些特定的膝关节系统无法适应。给定的 AP 尺寸下，切除的男性和女性胫骨往往比所有 TKA 系统都窄。
我们的研究结果提供了有关西班牙裔膝关节独特形态的有价值数据。这些数据可以帮助外科医生为这些患者选择最合适的 TKA 系统。
