ArticleKnee surgery & related research2025
Does undersizing of the tibial component in unicompartmental knee arthroplasty increase the risk of fracture? A biomechanical study.
Article in Knee surgery & related research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- AI-assisted preoperative planning improves component sizing accuracy in Oxford unicompartmental knee arthroplasty: a retrospective cohort study with 24-month follow-up.Journal of orthopaedic surgery and research · 2026Article
- Personalized Tibial Component Placement in Medial Unicompartmental Knee Arthroplasty: Surgical Technique and Rationale.Journal of clinical medicine · 2026Article
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8 authors.
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Abstract
backgroundUnicompartmental knee arthroplasty (UKA) is a common treatment for medial osteoarthritis, providing faster recovery and better joint kinematics than total knee arthroplasty (TKA). However, periprosthetic tibial plateau fractures (TPF) remain a significant complication. Undersized tibial components, especially size AA, increase TPF risk. This study aims to examine the biomechanical relation between tibial implant size and the risk of periprosthetic fractures.
methodsA biomechanical study was conducted using 16 customized synthetic bone models to simulate the effects of tibial component sizing in UKA. Proximal tibial models with components of size A and size AA were subjected to axial loading, and the maximum load to failure and cycles to failure were measured for each size. Additionally, plastic axial deformation was calculated at the maximum load level of the weakest construct. Strain patterns were compared with clinically observed fracture lines reported in previous studies.
resultsSize AA had a significantly lower maximum load and cycles to failure compared with size A (1039 N ± 75 N and 9.336 ± 925 cycles versus 1140 N ± 83 N and 8.326 ± 759 cycles, p = 0.031). The strain patterns were consistent with those observed in clinical studies, showing a wedge-shaped distribution from the posteromedial to the anteromedial tibial plateau. Plastic deformation was less than 0.6 mm across all specimens, with no significant difference in axial displacement between the two groups (p = 0.64).
conclusionUndersizing the tibial component reduces load-bearing capacity of the tibial plateau and thereby increases the risk of periprosthetic fractures. Precise implant sizing by correct sagittal resection is essential to minimize the risk of fracture in UKA. EXPERIMENTAL STUDY: Type V.
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