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Angled polyethylene insert exchange for sagittal tibial malalignment in total knee arthroplasty
Alexander P Sah1, Richard D Scott, Richard Iorio
1Department of Orthopedics, Massachusetts General Hospital, Boston, MA 02114-3117, USA.
The Journal of Arthroplasty
|January 1, 2008
Summary
Custom-angled inserts can correct tibial component malposition in total knee arthroplasty, potentially avoiding revision surgery. This rare procedure offers an alternative for sagittal alignment correction, though long-term results require further study.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
Background:
- Tibial component malposition in total knee arthroplasty (TKA) can lead to early failure and revision surgery.
- Excessive posterior slope is a challenging malalignment to correct, often risking further bone loss during revision.
Observation:
- A custom-angled bearing was used to correct sagittal malalignment in TKA.
- This approach aimed to avoid revision surgery and preserve tibial bone stock.
Findings:
- The custom-angled insert procedure demonstrated successful sagittal alignment correction.
- A 6-year follow-up indicated the potential effectiveness of this alternative approach.
Implications:
- Custom-angled inserts may offer a viable alternative to revision surgery for specific cases of tibial component malalignment.
- While simple and low-risk, cost and limitations for severe deformities necessitate selective use.