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Updated: May 14, 2026

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Mediolateral oversizing influences pain, function, and flexion after TKA.

Michel P Bonnin1, Axel Schmidt, Luca Basiglini

  • 1Centre Orthopédique Santy, 24 Av Paul Santy, 69008, Lyon, France, bonnin.michel@gmail.com.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|February 14, 2013
PubMed
Summary

Component oversizing in total knee arthroplasty (TKA) can negatively impact patient outcomes. This study found that larger implant sizes correlate with worse clinical results and pain after TKA surgery.

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering

Background:

  • Total knee arthroplasty (TKA) aims to restore function and reduce pain.
  • Manufacturers are developing narrower femoral components for improved bone-implant fit.
  • The clinical implications of mediolateral oversizing in TKA remain under-investigated.

Purpose of the Study:

  • To investigate the hypothesis that component oversizing negatively influences clinical outcomes after TKA.
  • To assess the correlation between implant size variation and patient results.

Main Methods:

  • Retrospective assessment of 114 TKAs in 112 patients (mean age 72 years).
  • Preoperative CT scans were used to measure femur and tibia dimensions.
  • Implanted TKA sizes were compared to patient anatomy to identify oversizing.

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  • Clinical outcomes, including pain and Knee injury and Osteoarthritis Outcome Score (KOOS), were evaluated one year post-surgery.

    • Main Results:

    • Mediolateral overhang was prevalent, observed in 66% of femurs and 61% of tibias.
    • Patients with no overhang reported better pain and KOOS scores compared to those with overhang.
    • Regression analysis revealed a significant negative correlation between overall oversizing and overall clinical outcome.

    Conclusions:

    • Component oversizing in TKA is associated with worse clinical results.
    • Surgeons should exercise caution to avoid oversizing implants during TKA procedures.
    • Oversizing should be considered as a potential cause for unexplained pain following TKA.