Long-Term Followup of the Miller-Galante Total Knee Replacement

Berger, Richard A.; Rosenberg, Aaron G.; Barden, Regina M.; Sheinkop, Mitchell B.; Jacobs, Joshua J.; Galante, Jorge O.

doi:10.1097/00003086-200107000-00010

Cited by 176 publications

(73 citation statements)

References 14 publications

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“…Total knee arthroplasty (TKA) is a clinically efficacious and cost-effective intervention, with high rates of success in terms of alleviating pain and improving function in patients with advanced arthritis of the knee [2,11,12,21,22,25]. However, there has been a steady rise in the volume of revision TKA procedures in the United States in recent years.…”

Section: Introductionmentioning

confidence: 99%

The Epidemiology of Revision Total Knee Arthroplasty in the United States

Bozic¹,

Kurtz²,

Lau³

et al. 2009

The Journal of Arthroplasty

102

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Understanding the cause of failure and type of revision total knee arthroplasty (TKA) procedures performed in the United States is essential in guiding research, implant design, and clinical decision making in TKA. We assessed the causes of failure and specific types of revision TKA procedures performed in the United States using newly implemented ICD-9-CM diagnosis and procedure codes related to revision TKA data from the Nationwide Inpatient Sample (NIS) database. Clinical, demographic, and economic data were reviewed and analyzed from 60,355 revision TKA procedures performed in the United States between October 1, 2005 and December 31, 2006. The most common causes of revision TKA were infection (25.2%) and implant loosening (16.1%), and the most common type of revision TKA procedure reported was all component revision (35.2%). Revision TKA procedures were most commonly performed in large, urban, nonteaching hospitals in Medicare patients ages 65 to 74. The average length of hospital stay (LOS) for all revision TKA procedures was 5.1 days, and the average total charges were $49,360. However, average LOS, average charges, and procedure frequencies varied considerably by census region, hospital type, and procedure performed.

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Section: Introductionmentioning

confidence: 99%

The Epidemiology of Revision Total Knee Arthroplasty in the United States

Bozic¹,

Kurtz²,

Lau³

et al. 2009

The Journal of Arthroplasty

102

View full text Add to dashboard Cite

show abstract

“…This may explain the parallel observation of debonding and radiolucencies. The expected long-term success of standard TKA should be at least 10 years as evidenced by studies which found 10 year 90% survivorship [2,18], and long-term patient satisfaction of 80% [1]. The standard tray used in our study (the Genesis II CR; Smith & Nephew) had a survivorship of 98% at 5 to 11 years followup (mean, 9.5 years) in a previous study [5].…”

Section: Discussionmentioning

confidence: 60%

“…A couple long-term followup studies of standard TKA have shown excellent results for pain reduction, functional improvement, and survivorship of 90% to 95% at 15 years [2,18]. Since minimally invasive surgery (MIS) in TKA has been introduced, the development of new surgical techniques, instruments, and implants has been driven forward.…”

Section: Introductionmentioning

confidence: 99%

Short-keeled Cemented Tibial Components Show an Increased Risk for Aseptic Loosening

Ries¹,

Heinichen²,

Dietrich³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background The choice of implant design plays an important role for primary fixation of a TKA. Short-keeled tibial components allow implantation through a smaller approach with less femorotibial subluxation. Questions/purposes The purpose of this study was to detect early implant failure resulting from aseptic loosening after cemented short-keeled and standard tibial baseplate implantation. Methods Between 2008 and 2010, a group of 160 consecutive patients (with 80 standard and with 80 shortkeeled tibial trays) received cemented TKAs. At 1-year followup, patients were examined clinically and radiographs were analyzed regarding aspects of radiolucency. The components were divided into five zones on each radiographic view and the measurements of the 10 zones were added. Results The mean sum of radiolucencies was increased significantly with the short-keeled baseplates. In the current study, short-keeled tibial trays revealed a revision rate of 6.3% after 1-year followup. In contrast, none of the standard tibial baseplates were revised. Conclusions The implantation of cemented, short-keeled tibial components is linked to an increased rate of early loosening. Therefore, the indication for cemented, shortkeeled component implantation should be reviewed. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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“…However, in this study there was only 1 of the 181 patients who underwent a prophylactic revision due to radiographic findings without experiencing pain or reduced physical function. In that particular case, the problem originated from a Miller-Galante-I prosthesis, which was made of titanium and which used a metalbacked patella, the combination of which led to a specific and well-reported failure pattern of wear with risk of metallosis (Berger et al 2001, Kraay et al 2001). According to our study, revisions of asymptomatic knee arthroplasties are unusual.…”

Section: Routine Follow-upmentioning

confidence: 99%

Revision in previously satisfied knee arthroplasty patients is the result of their call on the physician, not on pre-planned follow-up: A retrospective study of 181 patients who underwent revision within 2 years

et al. 2005

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BackgroundDegree of satisfaction with a knee arthroplasty is said to be correlated to reduced pain and better function. During a validation of the Swedish Knee Arthroplasty Register in 1997, previously operated patients were asked how satisfied they were with their knee. A subgroup of "satisfied" patients was identified who underwent revision within 2 years of having expressed satisfaction. Our aim was to study the revision diagnosis, to determine whether the problem leading to revision had been discovered as a result of routine follow-up, and also to find out when the symptoms leading to revision had started.Methods We retrospectively studied the medical records of 181 patients (181 knees), with a median age of 74 (31-88) years. 68% were women and the median time between primary operation and revision was 8 (3-21) years.Results Aseptic loosening (74/181) was the most common diagnosis. 2 cases were revised as a result of routine follow-up. 44% of the medical records included reports of pain in the replaced knee prior to answering the satisfaction questionnaire.Interpretation Few patients were admitted to knee revision surgery due to medical findings discovered during routine follow-up. The term "satisfaction" must be interpreted with care, as it seems to have a more complex meaning for the patients than absence of knee pain.

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Long-Term Followup of the Miller-Galante Total Knee Replacement

Cited by 176 publications

References 14 publications

The Epidemiology of Revision Total Knee Arthroplasty in the United States

The Epidemiology of Revision Total Knee Arthroplasty in the United States

Short-keeled Cemented Tibial Components Show an Increased Risk for Aseptic Loosening

Revision in previously satisfied knee arthroplasty patients is the result of their call on the physician, not on pre-planned follow-up: A retrospective study of 181 patients who underwent revision within 2 years

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