This prospective comparative study reflects level of evidence II.
The tibial slope is directly affected by the weight and measurements of the components, regardless of the instruments or the number of pegs, while clinical outcomes are correlated with implant position. The MP instrumentation seems to be effective in determining the tibial cut and, particularly, improving the tibial slope, compared with Ph-III. A positive correlation was noted between the femoral and tibial sizes and the tibial angle and the slope, and a negative correlation between weight and the tibial slope furthermore, a positive correlation was found between Oxford knee score and radiographic angles. A significant difference was found between Ph-III and MP in tibial slope in patients with body mass index (BMI) ≥25 kg/m2 (p = 0.0003). Similar results were found between small (AA, A, B) tibial size and large (C, D, E, F) tibial size for tibial varus/valgus (p = 0.03) angle and tibial slope (p = 0.003). Moreover, a significant difference was found in tibial angle and in tibial slope in arthroplasty with femoral size small (S), compared with size medium (M) or large (Ly) (tibia varus/valugs angle: p = 0.0484 tibial slope: p = 0.04). A significant difference was found on the slope between Ph-III and MP (p = 0.0005). No clinical differences were found among the three groups (p > 0.05). Postoperative alignment of the knee in the coronal and sagittal plane was measured using radiographs. The third cohort consisted of 24 hypoallergenic OUKA, using the MP instrumentation (TiNbN). The second cohort consisted of 136 OUKA, with the MP instrumentation. The first cohort consisted of 67 Oxford unicompartmental knee arthroplasty (OUKA), using the phase III (Ph-III). We prospectively analyzed clinical and radiographic outcomes of three consecutive cohorts for a total of 227 implants at a minimum follow-up of 36 months. The aim of the study is to evaluate whether the use of the new instrumentation Microplasty (MP) improves component positioning and the reliability of the surgical technique, reducing the implant outliers from the recommended range and providing a more accurate resection, while avoiding insufficient or excessive tibial resection and clinical scores.
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