Long Term Outcome of Total Knee Arthroplasty. Condylar Constrained Prostheses

Bargiotas, K.

doi:10.1007/978-1-4471-6660-3_18

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…For example, a constraint knee prosthesis as a salvage procedure for TKR may result in early loosening of the implant because of the rotational torque imparted from the ligament to the bone-cement interface. 12 – 14 Moreover, the constraint prosthesis is more expensive than a conventional knee prosthesis. Ligament balancing 3 , 4 is not recommended because of the paucity of such knee deformities, especially in developed countries.…”

Section: Discussionmentioning

confidence: 99%

Rotational Shortening of Collateral Ligament in TKR With Severe Deformity

Hwang

Cheng

et al. 2018

Techniques in Orthopaedics

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Instability of the knee joint after total knee replacement (TKR) is one of the most important reasons for revision TKR. Inadequate release or tightening of the collateral ligaments in the knee joint may cause instability and early failure. This study presents a case series study of a new technique for ligament balancing wherein the collateral ligament is detached from its origin and rotated (twisted) around its longitudinal axis to tighten the ligament before the origin is reattached to its original position. The surgical technique for collateral ligament tightening during TKR was performed on 6 patients with a deformed knee caused by osteoarthritis and rheumatoid arthritis. The range of motion, knee society score, and laxity of the patients’ knee joint, after 7 months to 13 years of follow-up, were evaluated. The technique was successful, achieving good range of motion and satisfactory stability of the joint. Further evaluation in a larger number of cases and a comparative analysis with different techniques would further support the usefulness of this rotational ligamentoplasty technique.

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Section: Discussionmentioning

confidence: 99%

Rotational Shortening of Collateral Ligament in TKR With Severe Deformity

Hwang

Cheng

et al. 2018

Techniques in Orthopaedics

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Early Clinical and Radiological Outcomes of the Metaphyseally Fixed Totally Stabilized Knee Prosthesis in Primary Total Knee Arthroplasty

et al. 2019

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The use of valgus–varus constrained (VVC) implant designs in primary total knee arthroplasty (TKA) is considered in situations of severe deformities, bone loss, and inadequate soft tissue balance. It is not known whether the use of such prosthesis designs may predispose to reduced function owing to its constraining design. The components are usually implanted with diaphyseal stem extensions to dissipate the increased forces. The totally stabilized (TS) implant is a contemporary VVC design with metaphyseal fixation only. It has a conforming articulation with increased rotational freedom compared with conventional VVC designs. The aim of this study was to assess whether the use of the contemporary TS implant with its metaphyseally fixed components would be associated with inferior outcomes compared with conventional standard primary posterior stabilized (PS) implants. We reviewed 38 consecutive complex primary TKAs performed using the metaphyseally fixed TS implant and 76 matched patients receiving primary PS TKA, at a minimum follow-up of 24 months. The mean follow-up was 61.1 months (24–102). Only patients with osteoarthritis were included. Clinical outcome was assessed using range of motion (ROM) and Oxford knee score (OKS). Radiographic assessment was performed using the femorotibial angle (FTA) at 6 weeks followed by assessment of bone–implant interface lucencies at final follow-up. There were no major early postoperative complications. The mean postoperative ROM in the TS and PS groups were 114.1 and 112.0, respectively. There was no difference in the mean ROM and OKS between the two groups. The mean FTA for patients in both groups was within 3° of the expected. There was no evidence of progressive lucencies or implant migration at final follow-up. The metaphyseally fixed TS knee design achieves comparable short-term functional outcomes when compared with conventional PS designs in primary knee arthroplasty. Long-term follow-up studies are required to assess survivorship.

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Long Term Outcome of Total Knee Arthroplasty. Condylar Constrained Prostheses

Cited by 2 publications

References 29 publications

Rotational Shortening of Collateral Ligament in TKR With Severe Deformity

Rotational Shortening of Collateral Ligament in TKR With Severe Deformity

Early Clinical and Radiological Outcomes of the Metaphyseally Fixed Totally Stabilized Knee Prosthesis in Primary Total Knee Arthroplasty

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