CT-based 3D bone shape modes are associated with clinically meaningful functional improvement after total knee...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Radiology

Background:

• Total knee arthroplasty (TKA) aims to improve patient function.
• The Knee Society Score Function subscore (KSS-Function) is a key outcome measure.
• Minimal clinically important difference (MCID) in KSS-Function is crucial for assessing TKA success.

Purpose of the Study:

• To investigate if preoperative 3D bone shape characteristics predict failure to achieve MCID in KSS-Function after TKA.
• To explore the association between statistical shape modeling of bone morphology and functional outcomes post-TKA.

Main Methods:

• Retrospective analysis of 151 patients undergoing robotic-assisted TKA.
• Preoperative CT scans used for 3D bone segmentation and statistical shape modeling of femur, tibia, and patella.
• Logistic regression analysis to assess associations between bone shape modes and MCID non-achievement, adjusted for sex and BMI.

Main Results:

• 15.9% of patients did not achieve KSS-Function MCID.
• Female sex and higher BMI were associated with higher odds of MCID non-achievement.
• Five bone shape modes, related to patellofemoral remodeling and tibial plateau contours, were significantly associated with MCID non-achievement.

Conclusions:

• Preoperative CT-derived 3D bone shape modes are associated with functional outcomes after TKA.
• Bone morphology may provide predictive insights into TKA success.
• Further validation in larger cohorts is needed to confirm the incremental value of bone shape analysis.