Modular Fixed-Bearing Total Knee Arthroplasty with Retention of the Posterior Cruciate Ligament

Dixon, Michael C.; Brown, R. R.; Parsch, Dominik; Scott, Richard D.

doi:10.2106/jbjs.c.00591

Cited by 161 publications

(96 citation statements)

References 22 publications

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“…Our review showed improvement in mean Knee Society clinical and functional scores that parallel the results reported in studies that have not separated patients on the basis of patient age [1,2,6,8,12,19,27,30]. Although physician-generated scores suggest improvement, reporting biases that appear to overlook negative patient experiences were identified during this review, including minimizing the impact of revision procedures for patellar resurfacing, polyethylene wear, instability, and stiffness (Table 1).…”

Section: Discussionsupporting

confidence: 68%

What is the Evidence for Total Knee Arthroplasty in Young Patients?: A Systematic Review of the Literature

Keeney

Eunice

Pashos

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background TKA is commonly performed to treat advanced inflammatory and degenerative knee arthritis. With increasing use in younger patients, it is important to define the best practices to enhance clinical performance and implant longevity. Questions/purposes We systematically reviewed the literature to assess: (1) how TKAs perform in young patients; (2) whether the TKA is a durable procedure for young patients, and (3) what guidance the literature outlines for TKA in young patients. Methods We searched the literature between 1950 and 2009 for all studies reporting on TKAs for patients younger than 55 years that documented clinical and radiographic assessments with a minimum 2-year followup. Thirteen studies, reporting on 908 TKAs performed for 671 patients, met these criteria. Results Mean Knee Society clinical and functional scores increased by 47 and 37 points, respectively. Implant survivorship was reported between 90.6% and 99% during the first decade and between 85% and 96.5% during the second decade of followup. The literature does not direct specific techniques for TKA for young patients.Conclusions TKA provides surgeon-measured clinical and functional improvements with a moderate increase in second-decade implant failures.

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Section: Discussionsupporting

confidence: 68%

What is the Evidence for Total Knee Arthroplasty in Young Patients?: A Systematic Review of the Literature

Keeney

Eunice

Pashos

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…The early infection rate of 1.4% (two cases) in our series is consistent with the overall literature data. The paper from Boston [6] reported no early or late infections in their cohort. Whether a single-versus multisurgeon setting might have had an influence on the early infection rate remains unclear.…”

Section: Discussionmentioning

confidence: 89%

“…However, the definition of failure of TKA has not been consistent in the literature. Dixon et al [6] presented a 93% survivorship of the PFC system (DePuy) at 15 years with re-operation for any reason as the endpoint in a single surgeon study assuming that all patients lost to follow-up had a failure of the implant (worst case scenario).…”

Section: Discussionmentioning

confidence: 99%

“…Our multisurgeon, one-institution, one-implant (PFC) study reflects a common set-up in which many patients We included all revisions in our survivorship analysis consistent with a previously published paper of the same implant [6], whereas Vessely et al [14] did not include periprosthetic fracture treatment, irrigation/debridement for infection, and other re-operations without component removal or revision of TKA components. However, we did not include two patients who might become candidates for revisions in the future, since at the time of the latest follow-up only clinical and radiographic controls were recommended.…”

Section: Discussionmentioning

confidence: 99%

“…Excellent long-term survivorship has been reported for nonmodular and modular TKA [1,6,8,10,11,13,14]. In 2005 Dixon et al reported excellent survivorship and function at a minimum of 15 years following modular fixed-bearing TKA with retention of the PCL (Pressfit condylar, PFC, DePuy Orthopaedics, Inc.).…”

Section: Introductionmentioning

confidence: 99%

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Follow-up of 11–16 years after modular fixed-bearing TKA

Parsch

Krüger

Moser

et al. 2008

International Orthopaedics (SICOT)

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To present representative data of long-term survivorship and clinical outcome for the PFC total knee arthroplasty (PFC-TKA). A consecutive series of 141 TKA was followed for a mean of 13 years (range, 11-16 years). Sixty-five knees were evaluated, 30 of these clinically and radiographically. Twenty-eight knees could only be assessed with the use of a questionnaire. Six patients were living in nursing homes. Fifty-four patients (65 knees) had died. Eleven had undergone a revision. One patient was considered lost to follow-up. With re-operation for any reason as the endpoint, the 10-year survival rate was 92% (n=91 patients at risk), and the 14-year survival rate was 91% (n=12). With aseptic loosening of the implant as the endpoint, the 10-and 14-year survival rates were 97%. The mean Knee Society and function scores were 76 and 48 points, respectively. In this multi-surgeon series modular fixed-bearing TKA had good clinical and radiographic results with excellent long-term survivorship.

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