Department of Orthopedic Surgery and Joint Surgery Center, Takatsuki General Hospital, Takatsuki City, Osaka, Japan.
J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(2):2309499020919309. doi: 10.1177/2309499020919309.
In unicompartmental knee arthroplasty (UKA), tibial components must be correctly sized and positioned so that tibial cut surfaces are well covered without marked under- or overhang with impingement of the surrounding soft tissue. We used morphometric data of both medial and lateral tibial plateaus separately to plan UKA and evaluated the compatibility of the measurement data to the dimensions of six currently available tibial prostheses in a Japanese population.
Using computed tomography, we preoperatively examined 60 patients (30 medial and 30 lateral osteoarthritis (OA)) scheduled for primary UKA at our hospital between 2013 and 2017. Each tibial cutting surface was measured in the transverse plane at 2 mm below the respective joint line. We used anteroposterior and mediolateral length to calculate the mediolateral length/anteroposterior ratio of both medial and lateral compartments. We then compared measurements across six current UKA systems: Oxford fixed tibia and fixed lateral tibia, Triathlon, TRIBRID, JOURNEY UNI, and HLS Uni Evolution.
We found no significant differences in morphometric data between the medial and the lateral OA. The cutting surface of lateral plateau, however, had smaller anteroposterior dimensions, greater mediolateral length, and higher mediolateral length/anteroposterior ratio than those of medial plateau. Therefore, in this Japanese population-based study, Oxford lateral tibia had good compatibility with the measurement data of lateral compartments.
Lateral compartments had lower anteroposterior length, greater mediolateral length, and higher mediolateral length/anteroposterior ratio than those of medial compartments. We, therefore, strongly recommend using Oxford fixed lateral tibia for lateral OA over other current tibial prostheses because of superior coverage.
在单间膝关节置换术（UKA）中，胫骨部件必须正确地进行尺寸设计和定位，以确保胫骨切割面得到充分覆盖，而不会出现周围软组织的明显遮挡或悬垂，以免发生撞击。我们分别使用内侧和外侧胫骨平台的形态计量学数据来规划 UKA，并评估这些测量数据与六种目前在日本人群中可用的胫骨假体尺寸的兼容性。
我们使用计算机断层扫描技术，对 2013 年至 2017 年期间在我院接受初次 UKA 的 60 例患者（30 例内侧和 30 例外侧骨关节炎（OA））进行了术前检查。每个胫骨切割面在相应关节线以下 2mm 的横断面上进行测量。我们使用前后径和内外径来计算内侧和外侧腔室的内外径/前后径比值。然后，我们比较了六种当前 UKA 系统的测量结果：Oxford 固定胫骨和固定外侧胫骨、Triathlon、TRIBRID、JOURNEY UNI 和 HLS Uni Evolution。
我们没有发现内侧和外侧 OA 之间的形态计量学数据有显著差异。然而，外侧平台的切割面前后径较小，内外径较长，内外径/前后径比值较高。因此，在这项基于日本人群的研究中，Oxford 外侧胫骨与外侧腔室的测量数据具有良好的兼容性。
与内侧腔室相比，外侧腔室的前后径较短，内外径较长，内外径/前后径比值较高。因此，我们强烈建议在外侧 OA 中使用 Oxford 固定外侧胫骨，而不是其他当前的胫骨假体，因为它具有更好的覆盖性。
