Proximal tibia morphologic analysis for the design of revision tibial component
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    Abstract:

    Objective Good coverage of tibial component and proximal resected tibial surface can improve the strength of component fixation and thus avoid component subsidence and loosening. Most prostheses used in Taiwan are imported from USA or Europe. Such tibial components don’t have good coverage for Taiwanese in our previous study. Especially in revision knee surgery, the shape is varied in different cutting thicknesses of the tibia, which makes it more difficult to have a good coverage of revision tibial component and resection surface. The purpose of this study was to investigate the proximal tibial morphology of Taiwanese. The results can be applied for geometric designs of tibial baseplate and augmentation. Methods Fifty osteoarthritis knees were collected for analysis. Three-dimensional proximal tibia was constructed from Computed-Tomography slices for measuring morphologic data. Five cutting depths of 4, 7, 10, 13, and 16mm below tibial plateau were measured. The parameters included the dimensions of anteroposterior length (AP), mediolateral width (ML) of resected surface and four radii as anterolateral radius (AL), posterolateral radius (PL), anteromedial radius (AM), and posteromedial radius (PM). Results The results showed that mean AP was 47.4mm(40.4-52.9), mean ML was 69.0mm (59.6-79.1), AL was 30.0 mm (18-38), PL was 20.0 mm (10-25), AM was 28.7 mm (18- 36), and PM was 17.9mm (11-23). Conclusion Comparing the results with commercial tibial components, the imported implants of PFC sigma and Zimmer Nexgen could provide better coverage for Taiwanese. Body height and dimensions of AP and ML present high dependence, and American and European is relatively taller than Taiwanese. The factor of body height may highly influence the covering rate of tibial components. This study suggested 5 sizes of tibial components for Taiwanese. They can improve the rate of coverage, and reduce the rate of implant subsidence.

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. Proximal tibia morphologic analysis for the design of revision tibial component[J]. Journal of medical biomechanics,2007,22(4):334-338

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