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Wedged tibial components for total knee arthroplasty

R S Jeffery1, M A Orton, R A Denham

  • 1Queen Alexandra Hospital, Portsmouth, United Kingdom.

The Journal of Arthroplasty
|August 1, 1994
PubMed
Summary

Tibial components with integral wedges improve fixation during total knee arthroplasty for severe coronal deformity. This enhanced component stability was observed without compromising postoperative alignment.

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Arthroplasty

Background:

  • Severe coronal knee deformity often involves tibial condyle erosion, complicating total knee arthroplasty (TKA).
  • Bone loss necessitates bone grafting, cement, or prosthetic augmentation to address tibial deficits.
  • Early TKA designs faced challenges in managing significant tibial bone defects.

Purpose of the Study:

  • To evaluate the efficacy of tibial components with integral polyethylene wedges in TKA for varus deformity.
  • To assess the impact of these wedged components on component fixation and postoperative alignment.
  • To compare outcomes of wedged components versus standard components in patients with tibial bone deficits.

Main Methods:

  • Retrospective comparison of 26 patients with varus deformity treated with wedged components against 29 historic control subjects.
  • Median follow-up of 8 years.
  • Radiographic analysis for component loosening and cement fracture.

Main Results:

  • No wedged components loosened, compared to loosening in five control subjects (P = .01).
  • Three control subjects exhibited fractured cement triangles on radiographs.
  • Postoperative alignment did not significantly improve with the use of wedged components.

Conclusions:

  • Tibial components with integral wedges provide improved fixation in TKA for varus deformity.
  • Enhanced fixation achieved with wedged components is independent of postoperative alignment.
  • Wedged components offer a reliable solution for managing tibial bone deficits in TKA.

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