Increased shape and size offerings of femoral components improve fit during total knee arthroplasty

Abstract

Purpose: Contemporary total knee arthroplasty femoral component designs offer various degrees of fit amongst the global population. The purpose of this study was to assess component fit of contemporary femoral component design families against multiple ethnicities. Methods: Using a multi-ethnic dataset including Caucasian, Indian, and Korean subjects, this study investigated component fit in six contemporary femoral component design families (A: Persona™, B: NexGen®, C: Sigma®, D: GENESIS™ II, E: Triathlon®, F: Vanguard®). Component overhang/underhang was measured between the resected distal femur and its corresponding component size and compared across design families and ethnicities. The severity of overhang/underhang and propensity of downsizing due to clinically significant overhang were quantified for the overall dataset and each ethnicity. Results: In all the overhang cases, Designs A and B had significantly lower component overhang than the other designs (p < 0.02). In all the underhang cases, Designs C and E had significantly greater underhang than the other designs (p < 0.01). Component design influenced the occurrence (% bones) of component downsizing due to clinically significant overhang (>3 mm), with the highest incidence observed in Designs D (20.5 %) and F (17.7 %), and the lowest incidence observed in Designs A (0 %) and B (0.4 %). Variation in component fit was significantly impacted by designs (p < 0.01) but not ethnicities (n.s.). Conclusions: The inclusion of multiple ML/AP shape offerings and the increased number of available sizes in Design A, as compared to other contemporary femoral component design families studied, result in improved femoral component fit across various ethnicities.