Comparison Between Standard and High-Flexion Posterior-Stabilized Rotating-Platform Mobile-Bearing Total Knee Arthroplasties

Choi, Won Chul; Lee, Sahnghoon; Seong, Sang Cheol; Jung, Jong Hun; Lee, Myung Chul

doi:10.2106/jbjs.i.01122

Cited by 50 publications

(62 citation statements)

References 23 publications

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“…Although they found no significant differences between high-flexion and standard TKA designs in terms of range of motion, knee scores, patient's satisfaction, and complications, the types of high-flexion and standard implants used in the randomized controlled trial were limited to NexGen knee system (Zimmer, Warsaw, IN) (LPS-flex [4,6,11,[23][24][25][26][27][28][29][30] or CR-flex [3,7]) or P.F.C. Sigma knee system (RP-F [1,2,31,32] or CR 150 [33]). Because both NexGen and P.F.C.…”

Section: Discussionmentioning

confidence: 99%

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Is High-Flexion Total Knee Arthroplasty a Valid Concept? Bilateral Comparison With Standard Total Knee Arthroplasty

Kim

Koh

et al. 2016

The Journal of Arthroplasty

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Section: Discussionmentioning

confidence: 99%

“…They found that femoral rollback and tibial internal rotation correlated with maximum flexion angle. The high-flexion knee prostheses were designed to enhance knee flexion by providing extended femoral condyles which allow posterior femoral rollback with increasing knee flexion [1,3,4].…”

Section: Discussionmentioning

confidence: 99%

Is High-Flexion Total Knee Arthroplasty a Valid Concept? Bilateral Comparison With Standard Total Knee Arthroplasty

Kim

Koh

et al. 2016

The Journal of Arthroplasty

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“…Early aseptic loosening of the femoral component reportedly occurs in 0% to 0.9% of patients at 2 to 10 years [4,10,27,29,44,48] in conventional TKA, and concerns have therefore been raised about the high incidence of early aseptic loosening in HF designs [7,17]. However, a number of clinical studies reporting 25 to 259 knees [3,8,20,[24][25][26] have suggested conflicting findings with only a few instances of prosthesis-related failures after HF TKA at mean followups of 12 to 51 months even in the same ethnic group [5,20,[24][25][26]41]. The risk of early aseptic loosening after HF TKA in large cohort studies is unclear.…”

Section: Introductionmentioning

confidence: 99%

High-flexion Prosthesis Improves Function of TKA in Asian Patients Without Decreasing Early Survivorship

Lee

Chung²,

Kim

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Two previous studies recently raised the possibility of a high risk of early femoral components loosening with high-flexion (HF) prostheses in Asian populations and suggested that the high failure rate of HF TKAs was associated with HF ability. However, these findings are controversial given other studies reporting a low incidence of aseptic failures in HF prostheses.Questions/purposes We therefore determined (1) the rate of achieving postoperative HF after HF TKA; (2) whether the aseptic loosening rate of HF prostheses is high; and (3) whether the survivorship was worsened in patients who achieved postoperative deep knee flexion in our cohort of Korean patients. Methods We retrospectively reviewed 488 patients who had 698 primary TKAs using the NexGen 1 Legacy Posterior-Stabilized Flex system implanted from 2003 to 2010. There were 40 men and 448 women with a mean age of 68 years. We obtained Hospital for Special Surgery scores, maximal flexion, and radiographs. The minimum followup for functional and radiographic evaluations was 2 years (median, 4.8 years; range, 2-8.7 years). We performed a survival analysis on all patients for aseptic loosening. Results Three hundred sixty knees (52%) could achieve C 135°maximum flexion. Six of the 698 knees (0.9%) developed aseptic loosening (three femoral and three tibial). The survival at 5 years for aseptic loosening was 99.1%. The overall survival for aseptic failure did not differ between knees that achieved HF and those that did not.

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“…Some studies reported that patients with a high-flexion knee prosthesis gained more ROM than those with a conventional knee prosthesis [19][20][21]. However, other studies did not find a significant difference in knee motion between the high-flexion and conventional knee components [22][23][24]. From the systematic literature review of outcomes following TKA using the high-flexion knee prosthesis, Murphy et al [25] reported that there was insufficient evidence of improved range of motion or functional performance after high-flexion knee arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Results of total knee arthroplasty with NexGen LPS-Flex for osteoarthritis in the valgus knee: a study of 26 patients followed for a minimum of 2 years

Nakano

Matsumoto

Muratsu³

et al. 2014

Eur J Orthop Surg Traumatol

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The present study aimed to examine the results of total knee arthroplasty (TKA) with the NexGen Legacy posterior-stabilized (LPS)-Flex system for osteoarthritis in the valgus knee. Between 2003 and 2011, 27 valgus knees in 26 patients who underwent TKA with the NexGen LPS-Flex implant were clinically and radiologically evaluated after a minimum follow-up of 2 years. The original diagnosis was osteoarthritis. Knee Society Knee Score (KSKS), Knee Society Function Score (KSFS), maximum flexion angle, maximum extension angle, and radiological femorotibial angle (FTA) were evaluated pre- and postoperatively. The mean KSKS improved from 42.6 before surgery to 82.2 by the final follow-up (p < 0.01), and the mean KSFS improved from 41.1 to 80.9 (p < 0.01). The mean maximum flexion angle changed from 109.1° to 117.3° (no statistical significance) and the maximum extension angle improved from -9.7° to -3.6° (p < 0.05) postoperatively. The postoperative radiological FTA was 172.4°, which was closer to a neutral angle (174°) than the preoperative FTA (166.4°) (p < 0.01). None of the patients had undergone revision surgery by the final follow-up. As a conclusion, TKA with the NexGen LPS-Flex implant for osteoarthritis in the valgus knee resulted in satisfactory improvement regarding objective outcomes, although a longer term follow-up with a greater number of cases is necessary to verify these results.

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Comparison Between Standard and High-Flexion Posterior-Stabilized Rotating-Platform Mobile-Bearing Total Knee Arthroplasties

Abstract: This prospective randomized study revealed no significant differences between standard and high-flexion posterior-stabilized rotating-platform mobile-bearing total knee prostheses in terms of clinical or radiographic outcomes or range of motion at a minimum of two years postoperatively.

Cited by 50 publications

References 23 publications

Is High-Flexion Total Knee Arthroplasty a Valid Concept? Bilateral Comparison With Standard Total Knee Arthroplasty

Is High-Flexion Total Knee Arthroplasty a Valid Concept? Bilateral Comparison With Standard Total Knee Arthroplasty

High-flexion Prosthesis Improves Function of TKA in Asian Patients Without Decreasing Early Survivorship

Results of total knee arthroplasty with NexGen LPS-Flex for osteoarthritis in the valgus knee: a study of 26 patients followed for a minimum of 2 years

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