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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 1, 31-36.
doi: 10.1302/0301-620X.90B1.19605  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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The relationship of the medially-offset stem of the tibial component to the medial tibial cortex in total knee replacements in Korean patients

J. H. Yoo, MD, Orthopaedic Surgeon1; Y. G. Kang, BSc, Clinical Investigator2; C. B. Chang, MD, PhD, Assistant Professor2; S. C. Seong, MD, PhD, Professor3; and T. K. Kim, MD, PhD, Assistant Professor2

1 Department of Orthopaedic Surgery, National Police Hospital, 58 Garak-dong Street, Songpa-gu, Seoul 138-708, Korea.
2 Joint Reconstruction Centre Seoul National University Bundang Hospital, 300 Gumidong, Bundang-gu, Seongnam-si, Gyeonnggi-do, 464-707, Korea.
3 Department of Orthopaedic Surgery, Seoul National University Hospital, 28 Yeongon-dong, Chongno-gu, Seoul 110-744, Korea.

Correspondence should be sent to Professor T. K. Kim; e-mail: osktk{at}snubh.org

We examined the placement of the stem in relation to the medial tibial cortex when using total knee replacements (TKRs) with medially-offset tibial stems in Korean patients. Measurements were performed on the pre- and post-operative radiographs of 246 osteoarthritic knees replaced between January 2005 and May 2006 using the Genesis II or E-motion TKR with a medially-offset stem. Pre-operatively, we measured the distance between the mechanical axis and that of the tibial shaft and post-operatively, that between the midline of the tibial stem and the axis of the shaft.

Knees were identified in which there was radiological contact between the tip of the stem and the medial tibial cortex. The mechanical axis was located medial to the axis of the shaft in 203 knees (82.5%). Post-operatively, the midline of the tibial stem was located medial to the tibial shaft axis in 196 knees (79.7%). In 16 knees (6.5%) there was radiological contact between the tibial stem or cement mantle and the medial tibial cortex.

Our study has shown that the medially-offset stem in the tibial component may not be a good option for knees undergoing replacement for advanced osteoarthritis in some Korean patients.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General