• Takao Kaneko, Norihiko Kono, Yuta Mochizuki, Hiroyasu Ikegami, and Yoshiro Musha.
• Department of Orthopedic Surgery, Toho University School of Medicine, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan. takao-knee@oha.toho-u.ac.jp.
• Arch Orthop Trauma Surg. 2018 Apr 1; 138 (4): 543-552.

IntroductionThis study asked whether differences in coronal alignment after total knee arthroplasty (TKA) affect the load distribution on the tibial plateau. The aim of this study was to investigate the correlation between coronal alignment and the load distribution on the tibial plateau after TKA, using three-dimensional multi-detector-row-computed tomography (3D-MDCT).Materials And MethodsIn this study, we performed 84 cementless TKA with porous tantalum modular tibial component (PTMT) and divided into three groups based on post-operative hip-knee-ankle (HKA) angle: varus alignment group (n = 22), (176° ≧) neutral alignment group (n = 45), (180° ± 3°), and valgus alignment group (n = 17) (184° ≦).The changes in bone quality parameters of trabecular patterns under peg of PTMT were interpreted as load distribution due to changes in alignment. The relationship between HKA angle and load distribution on the tibial plateau was analyzed every 6 months for 4.5 years by measuring Bone marrow contents/tissue volumes (mg/cm3) and bone volumes/tissue volumes (%) under peg of porous tantalum modular tibial component by visualizing three dimensionally with 3D-osteo-morphometry software.ResultsThere were no correlations between HKA angle and the load distribution on the tibial plateau after TKA at all periods. There was a significantly higher increase in the medial region than the lateral about the BMC/TV and BV/TV values, regardless of the post-operative alignment after TKA for all periods. The relative BMC/TV and BV/TV changes at medial region in varus alignment group were significantly lower than the neutral and the valgus alignment groups of pre-operative medial osteoarthritis of the knee.ConclusionsAs far, it can be concluded by the study and the methods used therein that there were no relationships between the load distribution on the tibial plateau and HKA angle after TKA.Level Of EvidenceTherapeutic study, Level III.

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