ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021
Anatomical tibial component is related to more medial tibial stress shielding after total knee arthroplasty in Korean patients.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Comparison of the coverage and rotation of asymmetrical and symmetrical tibial components: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2024Pooled it
- Considerable inter-individual variability of tibial geometric ratios renders bone-implant mismatch unavoidable using off-the-shelf total knee arthroplasty: a systematic review and meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- Radiographic features of bone ingrowth in highly porous cementless total knee arthroplasty with minimum 2-year follow-up.Arthroplasty (London, England) · 2026Article
- Does tibial sclerosis severity influence bone resorption risk following total knee arthroplasty? : finite element analysis considering implant design and surgical technique.Bone & joint research · 2026Article
- Effect of different constraining boundary conditions on simulated femoral stresses and strains during gait.Scientific reports · 2024Article
- Reducing the prosthesis modulus by inclusion of an open space lattice improves osteogenic response in a sheep model of extraarticular defect.Frontiers in bioengineering and biotechnology · 2023Article
- Biomechanical effect of anatomical tibial component design on load distribution of medial proximal tibial bone in total knee arthroplasty : finite element analysis indicating anatomical design prevents stress-shielding.Bone & joint research · 2022Article
- Stress shielding in total knee replacements: Comparative analysis between titanium and all-polyethylene bases at 10 years follow-up.Journal of orthopaedicsArticle
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aimed to investigate stress shielding of anatomical tibial components (ATCs) in comparison to conventional symmetric tibial components (STCs) in Korean patients which may be related to medial tibial bone loss.
method78 knees in 59 patients with ATCs (Persona™) and 74 knees in 58 patients with STCs (NexGen LPS-Flex™) were retrospectively reviewed. Radiographic parameters and clinical outcomes in both groups were compared. Logistic regression analysis was performed to identify risk factors for medial tibial bone loss.
resultsMedial tibial bone loss was significantly greater in the ATC group (1.6 ± 1.3 mm) than in the STC group (0.4 ± 0.8 mm) (p < 0.001). The ATC group showed a shorter distance between the distal metal tip and anteromedial cortex and higher invading into the sclerotic bone lesion (ISBL) than the STC group (p = 0.034 and p = 0.044, respectively). Multiple logistic regression analysis suggested ATC, a shorter distance to the anteromedial cortex, and the presence of ISBL as risk factors for medial tibial bone loss. The odds ratios of medial tibial bone loss according to type of prosthesis, distance to anteromedial cortex, and presence of ISBL were 6.25 (range 2.86-13.63, p < 0.001), 0.69 (range 0.51-0.93, p = 0.015), and 3.79 (range 1.56-9.21, p = 0.003), respectively. Notwithstanding, there was no difference in clinical outcomes between the two groups.
conclusionIn Korean patients, ATCs potentially causes greater medial tibial bone loss due to stress shielding than STCs. The design, however, does not yet appear to affect clinical outcomes at mid-term follow-up. LEVEL OF EVIDENCE: Retrospective cohort study, level III.
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