Polyethylene failure of metal—backed patellar components: 111 AGC total knees followedfor 7-22 months

Andersen, H. N.; Ernst, Carsten; Frandsen, Peter A.

doi:10.3109/17453679108993081

Cited by 37 publications

(15 citation statements)

References 5 publications

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“…Additionally, the metal backing provided a porous coating for cementless fixation. Shortly after the introduction of the metal-backed patellar component into clinical use, early and frequent failures of a variety of dome-shaped metal-backed patellar components became apparent [1,3,4,7,22,23,25,26,31,32,35,36]. In contrast to these reports of metal-backed patellar failures, other authors have reported long-term successful outcomes with metal-backed patellar components of a mobile-bearing design [19].…”

Section: Introductionmentioning

confidence: 52%

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Isolated All-polyethylene Patellar Revisions for Metal-backed Patellar Failure

Garcia

Kraay

Goldberg

2008

Clinical Orthopaedics &Amp; Related Research

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The outcome of isolated patellar component revisions after metal-backed patellar failure is variable with satisfactory results reported from 78% to 100%. To supplement information in the literature we determined the failure rate and the functional outcome based on the Knee Society clinical and roentgenographic evaluation systems of isolated patellar component revisions after metal-backed patellar component failure. We retrospectively reviewed 27 patients with 28 isolated patellar component revisions for metal-backed patellar component failure performed between 1988 and 2005. Twenty-five knees in 24 patients were available for review with a minimum followup of 24 months (mean, 90 months; range, 24-210 months).

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Section: Introductionmentioning

confidence: 52%

“…Failure of the metal-backed patellar component in TKA has been well documented throughout the literature [1,3,4,7,22,23,25,26,31,32,35,36]. This high rate of failure has subsequently led to the markedly decreased use of these components [12,16,31,36].…”

Section: Discussionmentioning

confidence: 99%

Isolated All-polyethylene Patellar Revisions for Metal-backed Patellar Failure

Garcia

Kraay

Goldberg

2008

Clinical Orthopaedics &Amp; Related Research

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“…A major concern when using a tourniquet is the risk of nerve damage secondary to ischemia and increased tourniquet time and pressure (Pedowitz 1991, Klenerman 1995, Olivecrona et al 2013). EMG changes have been studied, and thigh weakness and pain may be affected by the mechanical compression caused by a tourniquet (Saunders et al 1979, Worland et al 1997, Tai et al 2012).…”

Section: Discussionmentioning

confidence: 99%

Faster recovery without the use of a tourniquet in total knee arthroplasty

Ejaz¹,

Laursen

Kappel³

et al. 2014

Acta Orthopaedica

138

172

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Background and purposeTourniquet application is still a common practice in total knee arthroplasty (TKA) surgery despite being associated with several adverse effects. We evaluated the effects of tourniquet use on functional and clinical outcome and on knee range of motion (ROM).Patients and methods70 patients who underwent TKA were randomized into a tourniquet group (n = 35) and a non-tourniquet group (n = 35). All operations were performed by the same surgeon and follow-up was for 1 year. Primary outcomes were functional and clinical outcomes, as evaluated by KOOS and knee ROM. Secondary outcomes were intraoperative blood loss, surgical time and visibility, postoperative pain, analgesic consumption, and transfusion requirements.ResultsPatients in the non-tourniquet group showed a better outcome in all KOOS subscores and better early knee ROM from surgery to week 8. No difference was detected at the 6- and 12-month follow-ups. Postoperative pain and analgesic consumption were less when a tourniquet was not used. Surgical time and visibility were similar between groups. Intraoperative blood loss was greater when not using a tourniquet, but no postoperative transfusions were required.InterpretationThis study shows that TKA without the use of a tourniquet results in faster recovery in terms of better functional outcome and improved knee ROM. Furthermore, reduced pain and analgesic use were registered and no intraoperative difficulties were encountered.

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“…Although a well-fixed and stable metal-backed patellar component can be retained, we recommend revising all metal-backed patellar components to a cemented all-polyethylene patellar component because of the high incidence of catastrophic failures associated with metal-backed implants of many designs [1,5,7,25,28,39]. Rorabeck et al [38] similarly suggested surgeons should consider the revision of all metal-backed patellar components regardless of patellar component fixation, damage, or positioning.…”

Section: Retaining the Existing Patellar Componentmentioning

confidence: 99%

Management of the Deficient Patella in Revision Total Knee Arthroplasty

Garcia

Kraay

Conroy-Smith

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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There are a number of options available to manage the patella when revising a failed total knee arthroplasty. If the previous patellar component is wellfixed, undamaged, not worn, and compatible with the femoral revision component, then it can be retained. When a patellar component necessitates revision and is removed with adequate remaining patellar bone stock, an onlay-type all-polyethylene cemented implant can be used. Management of the patella with severe bony deficiency remains controversial. Treatment options for the severely deficient patella include the use of a cemented all-polyethylene biconvex patellar prosthesis, patellar bone grafting and augmentation, patellar resection arthroplasty (patelloplasty), performing a gull-wing osteotomy, patellectomy, or the use of newer technology such as a tantalum (trabecular metal) patellar prosthesis. Severe patellar bone deficiency is a challenging situation because restoration of the extensor mechanism, proper patellar tracking, and satisfactory anatomic relationships with the femoral and tibial components are critical for an optimal clinical outcome.

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Polyethylene failure of metal—backed patellar components: 111 AGC total knees followedfor 7-22 months

Cited by 37 publications

References 5 publications

Isolated All-polyethylene Patellar Revisions for Metal-backed Patellar Failure

Isolated All-polyethylene Patellar Revisions for Metal-backed Patellar Failure

Faster recovery without the use of a tourniquet in total knee arthroplasty

Management of the Deficient Patella in Revision Total Knee Arthroplasty

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