The clinical significance of proximal tibial resection level in total kneearthroplasty

Clinical and radiographic data were collected in 139 patients with 195 post erior cruciate retaining total condylar knee prostheses to evaluate the rel ationship of the proximal tibial resection level with long term results. Am ong the 139 patients were 75 patients with 106 total knee replacements obse rved for more than 8 years. All patients underwent biyearly routine examina tions, including radiographs and clinical evaluations. The average medial t ibial resection for the 139 patients with 195 total knee replacements was 2 .95 mm, and in the subset of 75 patients (106 knees) observed for more than 8 years, it was 3.3 mm; both groups had a maximum of 14 mm, Sixty-three pe rcent or 67 knees had medial resection levels of 3 mm or less. The average lateral tibial resection for the 195 knees was 5.38 mm and in the 106 knees was 5.71 mm, with a maximum of 22 mm, Fifty-one percent of 104 knees had l ateral resection levels of 5 mm or less, Statistical analysis showed that t here was no significant correlation between the level of proximal tibial re section and Knee Society knee score, range of motion, radiolucencies, or lo osening or revision, These long term results suggest that minimal proximal tibial resection is not necessary for a successful arthroplasty, and proble ms associated with minimal resection, such as joint line elevation and thin polyethylene inserts, can be avoided.