RT Journal
A1 Tang, Qiheng
A1 Zhou, Yixin
A1 Yang, Dejin
A1 Xu, Haijun
A1 Liu, Qing
T1 The Offset of the Tibial Shaft from the Tibial Plateau in Chinese People
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2010
FD August 18
VO 92
IS 10
SP 1981
OP 1987
DO 10.2106/JBJS.I.00969
UL http://dx.doi.org/10.2106/JBJS.I.00969
AB Background: 
  Long-stem tibial components are available for complex primary and revision total knee arthroplasties. Most of the stems' designs are based on anatomic data from Western populations. We conducted a morphologic study to determine the relationship of the tibial shaft to the tibial plateau in Chinese people.Methods: 
  We included knees from fifty Chinese individuals (twenty-five females and twenty-five males) in this study. On magnetic resonance imaging scans of the tibial plateau and the proximal part of the tibial shaft of each lower limb, the distance between the axis of the tibial shaft and the center of the tibial plateau was measured and was defined as the offset of the tibial shaft from the tibial plateau at three resection levels: the first just distal to the subchondral bone of the medial tibial plateau, the second 5 mm distal to it, and the third 10 mm distal to it. The dimensions of the tibial plateau were measured as well.Results: 
  At the first, second, and third resection levels, the mean tibial shaft offsets (and standard deviations) from the center of the tibial plateau were, respectively, 7.23 ± 2.44 mm (3.40 ± 1.94 mm of mediolateral offset and 6.22 ± 2.05 mm of anteroposterior offset), 6.33 ± 2.26 mm (3.14 ± 2.04 mm of mediolateral offset and 5.24 ± 1.96 mm of anteroposterior offset), and 4.75 ± 2.07 mm (2.68 ± 1.91 mm of mediolateral offset and 3.46 ± 2.03 mm of anteroposterior offset). At each resection level, the mean offset in the male group was significantly larger than that in the female group.Conclusions: 
  There is a large variation in the offset of the tibial shaft from the tibial plateau in Chinese people. The axis of the tibial shaft is located anterolateral to the center of the tibial plateau in this population.Clinical Relevance: 
  The use of an anterolaterally offset tibial keel or stem seems more suitable for Chinese patients undergoing primary or revision total knee arthroplasty.