Measurement of proximal tibial morphology in northeast Chinese population based on three-dimensional reconstruction computer tomography

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Abstract

Tibial component of total knee arthroplasty (TKA) is designed according to morphology of proximal tibia to a large extent. Owing to racial difference, current design of tibial component based on Caucasian may not be suitable for Chinese patients. Meanwhile, data of proximal tibial morphology in Chinese population is lacking. The objective of this research was to investigate proximal tibial morphology of northeast Chinese population.

Computer tomography (CT) image of 164 northeast Chinese participants was collected. After three-dimensional (3D) reconstruction, size of tibia plateau and TKA resected surface were gauged to guide the design of TKA tibia prothesis in northeast Chinese population. Measurement of tibial size mainly includes tibial mediolateral length (tML), tibial medial/lateral anteroposterior length (tMAP and tLAP). Afterwards, tML/tAP ratio of tibia plateau and TKA resected surface were calculated as feature point of tibia prothesis. tMAP/tLAP ratio of TKA resected surface was calculated to represent tibial asymmetry degree. Medial and lateral posterior tibial slope (MPTS and LPTS) were also measured to give reference to posterior angle of tibia prothesis and angle of tibia osteotomy in TKA. Independent sample t test was performed to conduct statistical analysis, P < .05 was regarded as statistically significance.

Northeast Chinese male has larger knee size than female. Significant difference of tML/tAP ratio was also observed between male and female on tibia plateau (1.71 ± 0.07 vs 1.77 ± 0.09) but not on TKA resected surface (1.60 ± 0.05 versus 1.61 ± 0.06). Significant difference of tMAP/tLAP ratio between male and female was also found and they were 1.31 ± 1.03 and 1.11 ± 0.05 respectively. Northeast Chinese female has higher PTS than male (MPTS: 9.56 ± 2.96° vs 8.81 ± 2.87° and LPTS: 8.57 ± 3.19° vs 8.44 ± 2.76°).

Significant gender-difference of tibial size and asymmetry degree of tibial resected surface were found between northeast Chinese male and female. Meanwhile, northeast Chinese population has smaller knee size, larger PTS and tML/tAP ratio than that of Caucasian population. Therefore, Chinese-specific and gender-specific tibial prostheses were strongly recommended to be designed.

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The relationship between the survival of total knee arthroplasty and postoperative coronal, sagittal and rotational alignment of knee prosthesis.

Hye Yun Park, Yeong Kim, Tai-Hoo Kim … (2014)

Our study sought to address four issues: (1) the relationship between postoperative overall anatomical knee alignment and the survival of total knee prostheses; (2) the relationship between postoperative coronal alignment of the femoral and tibial component and implant survival; (3) the relationship between postoperative sagittal alignment of the femoral and tibial components and implant survival; and (4) the relationship between postoperative rotational alignment of the femoral and tibial component and implant survival. We reviewed 1,696 consecutive patients (3,048 knees). Radiographic and computed tomographic examinations were performed to determine the alignment of the femoral and tibial components. The mean duration of follow-up was 15.8 years (range, 11-18 years). Thirty (1.0%) of the 3,048 total knee arthroplasties failed for a reason other than infection and periprosthetic fracture. Risk factors for failure of the components were: overall anatomical knee alignment less than 3° valgus, coronal alignment of the femoral component less than 2.0° valgus, flexion of the femoral component greater than 3°, coronal alignment of the tibial component less than 90°, sagittal alignment of the tibial component less than 0° or greater than 7° slope, and external rotational alignment of the femoral and tibial components less than 2° In order to improve the survival rate of the knee prosthesis, we believe that a surgeon should aim to place the total knee components in the position of: overall anatomical knee alignment at an angle of 3-7.5° valgus; femoral component alignment, 2-8.0° valgus; femoral sagittal alignment, 0-3°; tibial coronal alignment, 90°; tibial sagittal alignment, 0-7°; femoral rotational alignment, 2-5° external rotation; and tibial rotational alignment, 2-5° external rotation.

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Novel measurement technique of the tibial slope on conventional MRI.

Robert Hudek, Silvia Schmutz, Felix Regenfelder … (2009)

The posterior inclination of the tibial plateau, which is referred to as posterior tibial slope, is determined routinely on lateral radiographs. However, radiographically, it is not always possible to reliably recognize the lateral plateau, making a separate assessment of the medial and lateral plateaus difficult. We propose a technique to measure the plateaus separately by defining a tibial longitudinal axis on a conventional MRI. The medial plateau posterior tibial slope obtained from radiographs was compared with MR images in 100 consecutive patients with knee pain when ligament or meniscal injury was assumed. The posterior tibial slope on MRI correlated with those on radiographs. The mean posterior tibial slope was 3.4 degrees smaller on MRI compared with radiographs (4.8 degrees +/- 2.4 degrees versus 8.2 degrees +/- 2.8 degrees , respectively). The reproducibility was slightly better on radiographs than MRI (+/- 0.9 degrees versus +/- 1.4 degrees ). Twenty-one of the 100 cases had more than a 5 degrees difference (range, -8.7 degrees to 8.9 degrees ) between the medial and lateral plateaus. The proposed technique allows measurement of the posterior tibial slope of the medial and lateral plateaus on a standard knee MRI. By using this novel measurement technique, a reliable assessment of the medial and lateral tibial plateaus is possible.

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Differences of knee anthropometry between Chinese and white men and women.

Bing Yue, Kartik M Varadarajan, Songtao Ai … (2011)

Whether there are differences in knee anthropometry between Asian and white knees remains unclear. Three-dimensional knee models were constructed using computed tomography or magnetic resonance imaging of healthy Chinese and white subjects. The morphologic measurements of the femur included mediolateral, anteroposterior dimensions, and aspect ratio. The tibial measurements included mediolateral, medial/lateral anteroposterior dimension, aspect ratio, and posterior slope of medial/lateral plateau. The results showed that Chinese knees were generally smaller than white knees. In addition, the femoral aspect ratio of Chinese females was significantly smaller than that of white females (1.24 ± 0.04 vs 1.28 ± 0.06). Tibial aspect ratio differences between Chinese and white males (1.82 ± 0.07 vs 1.75 ± 0.11), though significant, were likely a reflection of differences in knee size between races. These racial differences should be considered in the design of total knee arthroplasty prosthesis for Asian population. Copyright © 2011 Elsevier Inc. All rights reserved.

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Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: November 2019

Publication date (Electronic): 11 November 2019

Volume: 98

Issue: 45

Electronic Location Identifier: e17508

Affiliations

[a ]Department of Orthopedics, the Second Hospital of Jilin University

[b ]Emergency department, Hospital of Stomatology of Jilin University

[c ]Clinical laboratories, the Second Hospital of Jilin University, Changchun, Jilin Province

[d ]Department of plastic surgery, Mylike Medical Cosmetology Hospital, Shanghai

[e ]Department of Anesthesiology, Qingdao University Hospital, Qingdao, Shandong Province, China.

Author notes

[∗ ]Correspondence: Jincheng Wang, Department of Orthopedics, the Second Hospital, Jilin University, Changchun, Jilin, PR China (e-mail: jinchengwangjlu@ 123456163.com ); Haichen Chu, Department of Anesthesiology, Qingdao University Hospital, Qingdao, Shandong Province, PR China (e-mail: 18661805897@ 123456163.com ).

Article

Publisher ID: MD-D-19-01091 Accession ID: 17508

DOI: 10.1097/MD.0000000000017508

PMC ID: 6855598

PubMed ID: 31702611

SO-VID: b77b2ad4-54ba-4feb-a5ae-79566cbae0af

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This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

History

Date received : 7 February 2019

Date revision received : 31 August 2019

Date accepted : 16 September 2019

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Keywords: chinese population,computer tomography,tibial morphology,total knee arthroplasty

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Keywords: chinese population, computer tomography, tibial morphology, total knee arthroplasty

Measurement of proximal tibial morphology in northeast Chinese population based on three-dimensional reconstruction computer tomography

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Most cited references 24

The relationship between the survival of total knee arthroplasty and postoperative coronal, sagittal and rotational alignment of knee prosthesis.

Novel measurement technique of the tibial slope on conventional MRI.

Differences of knee anthropometry between Chinese and white men and women.

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