Results and complications of the low contact stress knee prosthesis

Sánchez-Sotelo, Joaquín; Ordóñez, J. M.; Prats, S. Bello

doi:10.1016/s0883-5403(99)90031-1

Cited by 50 publications

(17 citation statements)

References 11 publications

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“…In previously reported series, 6,7,12,20,26 dislocation of a mobile-bearing element occurred in less than 2.5% of cases, although Bert 4 reported an incidence of 9.3%. Tibial insert dislocation occurred in 2% of prostheses (seven rotating-platform, three meniscal-bearing) in the current study.…”

Section: Discussionmentioning

confidence: 81%

Long-Term Results of Low Contact Stress Mobile-Bearing Total Knee Replacements

Huang¹,

Ma²,

Lee³

et al. 2003

Clinical Orthopaedics &Amp; Related Research

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Five hundred ninety-eight consecutive primary low contact stress total knee replacements were done in 502 patients between 1985 and 1990. Clinical review was available for 495 knees (406 patients), 228 knees with meniscal-bearing prostheses and 267 knees with rotating-platform prostheses. The average followup was 12 years (range, 10-15 years). The average postoperative knee and functional scores were 87 points and 75 points, respectively. The average postoperative range of motion was 110 degrees. Fifty-six knees (11%) required revision for excessive wear of the tibial insert (41), dislocation (10), patellar polyethylene breakage (one), component loosening (one patellar, one tibial), and infection (two). During revision, osteolysis (20 knees), patellar polyethylene failure (33), and femoral component fracture (one) were seen. The overall survivorship was 88.1% at 15 years using Kaplan-Meier analysis. The survival rate was 83% for the meniscal-bearing prostheses and 92.1% for the rotating-platform prostheses. The Low Contact Stress mobile-bearing knee prosthesis has no superiority over that of fixed-bearing knees, especially for the meniscal-bearing design in prevention of polyethylene failure or revision. Based on the results of this study, the use of the LCS meniscal-bearing prosthesis does not appear to be justified.

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Section: Discussionmentioning

confidence: 81%

Long-Term Results of Low Contact Stress Mobile-Bearing Total Knee Replacements

Huang¹,

Ma²,

Lee³

et al. 2003

Clinical Orthopaedics &Amp; Related Research

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“…Other reports evaluating the LCS prosthesis that have included radiographic analysis have rarely encountered osteolysis [8,12,29,30,54]. Nonetheless, it has been noted to have occurred [47].…”

Section: Discussionmentioning

confidence: 99%

International multi-centre survivorship analysis of mobile bearing total knee arthroplasty

Stiehl

Hamelynck

Voorhorst³

2006

International Orthopaedics (SICO

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We retrospectively reviewed the experience of a large international multi-centre study of primary total knee arthroplasty with mobile bearing design and modifications of the tibial component to allow for bicruciate preservation, posterior cruciate retention, or sacrifice. Twenty-seven surgeons performed 4,743 total knee replacements between 1981 and 1997. Implants inserted were 324 that retained both cruciate ligaments, 2,165 that retained the posterior cruciate, and 2,254 that sacrificed both cruciates. The patella was resurfaced in 2,838 and unresurfaced in 1,905. With failure defined as revision or reoperation for any reason, the overall survivorship was 79% at 16 years' follow-up. Revision occurred in 259 (5.4%) knees out of the entire cohort. The risk adjusted rates of failure were higher in females, younger patients, osteoarthritis, posttraumatic arthritis, and in patients who had a meniscal bearing prosthesis or patellar resurfacing. The most common cause of revision was bearing-related issues including chronic instability, bearing subluxation, bearing dislocation, or bearing wear in 2.3%.Résumé Nous avons revu rétrospectivement une série multicentrique de prothèses totales primaires de genoux avec plateaux mobiles et pièce tibiale permettant le sacrifice ou la conservation d'un ou des deux ligaments croisés. Entre 1981Entre et 1997 prothèses ont été faite par 27 chirugiens. Les implants utilisés étaient pour 2254 sans ligaments croisés, pour 2165 avec croisé postérieur et pour 324 avec conservation des 2 croisés. La rotule a été resurfacée 2838 fois. Avec l'échec défini par la reprise chirurgicale, la survie était de 79% à 16 ans de recul. Une reprise a été faite 259 fois (5,4%). Le risque d'échec était plus grand chez les femmes, les patients jeunes, en cas d'arthrose primaire ou post traumatique et chez les patients avec une prothèse à ménisques mobiles ou avec une rotule prothèsée. Les causes les plus fréquentes de révision étaient l'instabilité chronique, la subluxation ou la luxation des plateaux mobiles et leur usure.

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“…Numerous studies of prostheses with a fixed-bearing design report an incidence of osteolysis ranging from 0.3% to 27% at 4.3 to 15.5 years followup after TKA [1, 7, 10, 14, 17, 18, 26-28, 30-32, 34]. Other studies of prostheses with a mobilebearing design report an incidence ranging from 0% to 7% at 9 to 15 years followup [6,8,9,21,22,25,27,33,35]. However, all of these reports on the incidence of osteolysis present combined data for failed and/or well-functioning fixed-and mobile-bearing TKAs in an older population (C 65 years).…”

Section: Introductionmentioning

confidence: 99%

Osteolysis in Well-functioning Fixed- and Mobile-bearing TKAs in Younger Patients

Kim

Choi

Kim

2010

Clinical Orthopaedics &Amp; Related Research

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Background Periprosthetic osteolysis is an increasingly prevalent complication of TKA. To reduce the polyethylene wear and periprosthetic osteolysis, particularly in young patients, the design of the contemporary fixed-bearing TKAs has been modified and mobile-bearing TKAs have been introduced. Questions/purposes We asked whether the prevalence of osteolysis would be less in well-functioning mobile-bearing TKAs than in well-functioning contemporary fixedbearing TKAs in young patients. Patients and Methods We compared 488 patients (894 knees) who received fixed-bearing knee prostheses with 445 patients (816 knees) who received mobile-bearing knee prostheses. There were 187 men and 301 women (mean age, 58.6 years; range, 33-65 years) in the fixedbearing group and 167 men and 278 women (mean age, 55.7 years; range, 33-65 years) in the mobile-bearing group. The mean followup was 12.6 years (range, 10-17 years) in the fixed-bearing group and 12.9 years (range, 10-17 years) in the mobile-bearing group. ResultsThe incidence of osteolysis was 1.6% (14 of 894 knees) in the fixed-bearing group and 2.2% (18 of 816 knees) in the mobile-bearing group at the final review. The mean postoperative Knee Society knee and function scores were 92.9 points and 83.5 points, respectively, in the fixedbearing group and 90.7 points and 83.8 points, respectively, in the mobile-bearing group. The revision rates were 3.7% (33 of 894 knees) in the fixed-bearing group and 2.7% (22 of 816 knees) in the mobile-bearing group. Conclusions We found the incidence of osteolysis, rate of revision, and implant survivorship were similar between fixed-bearing and mobile-bearing TKAs in younger patients. Level of Evidence Level III, therapeutic study. See the guidelines for authors for a complete description of levels of evidence.

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Results and complications of the low contact stress knee prosthesis

Cited by 50 publications

References 11 publications

Long-Term Results of Low Contact Stress Mobile-Bearing Total Knee Replacements

Long-Term Results of Low Contact Stress Mobile-Bearing Total Knee Replacements

International multi-centre survivorship analysis of mobile bearing total knee arthroplasty

Osteolysis in Well-functioning Fixed- and Mobile-bearing TKAs in Younger Patients

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