title: Tibial base design and patient morphology affecting tibial coverage and rotational alignment after total knee arthroplasty.
abstract: OBJECTIVE
  To understand interactions between total knee arthroplasty tibial base design attributes, variations in tibial morphology, and the resulting tibial coverage and rotational alignment.
  
  
  METHODS
  Tibial anthropometric measurements, including aspect ratio (medial-lateral width/anterior-posterior length) and tibial asymmetry, were taken for 14,791 total knee arthroplasty patients and compared with the ability of four different commercial tibial base designs to cover the resected plateau. The anthropometric measurements were also compared with the resulting tibial base rotation, which occurred when rotating the base to maximize coverage.
  
  
  RESULTS
  All four tibial base designs resulted in similar coverage ranging from 80.2 (4.7)% to 83.8 (4.6)%. Mean tibial base rotation when placed to maximize coverage ranged from 3.7 (4.4)° (internal) to 3.8 (4.5)° (external) relative to the medial third of the tibial tubercle. More asymmetric tibiae and tibiae with a lower aspect ratios resulted in increased internal tibial base rotation.
  
  
  CONCLUSIONS
  The four tibial base designs assessed provided similar levels of tibial bone coverage across the patient population, despite different design features. Rotating the tibial base to maximize coverage did not significantly increase the tibial coverage, but induced variability in tibial base alignment. Certain tibial anthropometrics may predispose particular patients to internal tibial base mal-rotation.
authors.affiliation: DePuy Synthes Joint Reconstruction, 46582, Warsaw, IN, USA, cclary1@its.jnj.com.
authors.forename: Chadd
authors.initials: C
authors.lastname: Clary
authors.forename: Luke
authors.initials: L
authors.lastname: Aram
authors.forename: Daren
authors.initials: D
authors.lastname: Deffenbaugh
authors.forename: Mark
authors.initials: M
authors.lastname: Heldreth
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D001837:Body Weights and Measures; D017760:Bone Malalignment / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging* / Q000601:surgery; D011474:Prosthesis Design; D012399:Rotation; D013977:Tibia / Q000601:surgery*; D014057:Tomography, X-Ray Computed