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CC BY-NC-ND-license · Joints 2014; 02(02): 76-80
DOI: 10.11138/jts/2014.2.2.076
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Analysis of differences in bone removal during femoral box osteotomy for primary total knee arthroplasty

Angelo Graceffa
1   Orthopaedics Clinic, University of Catania, Italy
,
Pier Francesco Indelli
2   Centro Eccellenza Sostituzioni Articolari Toscana (CESAT), Orthopaedics Clinic, University of Florence, Italy – Fondazione Onlus “...In Cammino...”, Fucecchio, Italy
3   Breyer Center for Overseas Study, Stanford University in Florence, Italy
4   Orthopaedics Clinic, University of Florence, Italy
,
Kaitlyn Basnett
3   Breyer Center for Overseas Study, Stanford University in Florence, Italy
,
Massimiliano Marcucci
2   Centro Eccellenza Sostituzioni Articolari Toscana (CESAT), Orthopaedics Clinic, University of Florence, Italy – Fondazione Onlus “...In Cammino...”, Fucecchio, Italy
4   Orthopaedics Clinic, University of Florence, Italy
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Publication History

Publication Date:
19 September 2017 (online)

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Abstract

Purpose: this study was conducted to compare the quantity of intercondylar bone removed during femoral box osteotomy for implantation of three contemporary posterior stabilized (PS) total knee arthroplasty designs: Sigma PS (DePuy), Vanguard (Biomet) and Persona (Zimmer).

Methods: we compared the maximum volumetric bone resection required for the housing of the PS mechanism of these three designs. Bone removal by each PS box cutting jig was three-dimensionally measured. The differences between the three designs were analyzed by the Kruskal-Wallis test. The Mann-Whitney U-test was used for pairwise comparisons. The level of significance was set at p<0.05.

Results: for small-size implants, the average box osteotomy volume of Persona was significantly smaller than the Vanguard and Sigma PS volumes (p=0.003). The mean difference between Vanguard and Sigma PS (p=0.01) was also significant. For medium size implants, the mean difference between Persona and Sigma PS (p=0.008) and the mean difference between Vanguard and Sigma PS (p=0.01) were statistically significant. For large size implants, the mean difference between Vanguard and Sigma PS (p=0.01) and the mean difference between Sigma PS and Persona (p=0.008) were statistically significant.

Conclusions: irrespective of implant size, the Persona cutting jig always resected significantly less bone than did Vanguard and Sigma PS.

Clinical Relevance: although this study does not establish any clinical relevance of removing more or less bone at primary TKA, its results suggest that if a PS design is indicated, it is preferable to select a model which resects less distal femoral bone.

Key Words

bone resection - box osteotomy - cruciate substituting - posterior stabilized - total knee arthroplasty