The effect of central stem and stem length on micromovement of the tibial tray

Yoshii, Ichiro; Whiteside, Leo A.; Milliano, Michael T.; White, Stephen E.

doi:10.1016/s0883-5403(07)80036-2

Cited by 59 publications

(21 citation statements)

References 8 publications

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“…Considering the stem design, it has to be taken into account that a stemmed baseplate has a higher fixation area and therefore gives the implant more stability in deep flexion and reduces tilting forces. This is in line with the observations of Yoshii et al [29] and Kraemer et al [15] who concluded that a stemmed tibial implant reduces the tendency for liftoff and subsidence in the frontal and sagittal planes. The use of an intramedullary stem and avoidance of varus-valgus malpositioning of components have been advocated to reduce the mentioned bone-implant stresses [17,28].…”

Section: Discussionsupporting

confidence: 92%

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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Section: Discussionsupporting

confidence: 92%

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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“…Numerous reports have shown midterm clinical success with NMCCK design prostheses [1, 2, 11] and our [12,15,17]. Indeed, while the overall revision rate was low for NMCCK, it was, nonetheless two times higher than for the PS implants, and this is consistent with the possibility of mechanical problems.…”

Section: Discussionsupporting

confidence: 85%

Comparison of Revision Rates of Non-modular Constrained Versus Posterior Stabilized Total Knee Arthroplasty: a Propensity Score Matched Cohort Study

Moussa¹,

Lee²,

Westrich³

et al. 2016

HSS Jrnl

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Background: Attaining stability during total knee arthroplasty (TKA) is essential for a successful outcome. Although traditional constrained total knee prostheses have generally been used in conjunction with intramedullary stems, some devices have been widely used without the use of stems, referred to as non-modular constrained condylar total knee arthroplasty (NMCCK). Questions/Purposes: The aim of this study was to compare revisions rates after total knee replacement with a non-modular constrained condylar total knee (NMCCK) compared to a posterior-stabilized (PS) design. Methods: Between 2007 and 2012, primary PS total knees were compared with NMCCK implants from the same manufacturer. Propensity score matching was performed, and implant survivorship was examined using a Cox proportional hazards model. The cohort consisted of 817 PS knees and 817 NMCCKs matched for patient demographics, surgeon volume, and pre-operative diagnosis. Results: All cause revisions occurred in 11 of 817 (1.35%) in the PS group compared to 28 of 817 (3.43%) in the NMCCK group (p = 0.0168). Excluding revisions for infection and fracture, 8 of 817 (0.98%) PS knees required revision for mechanical failure compared to 18 of 817 (2.20%) NMCCK knees (p = 0.0193). Conclusions: While revisions rates in both cohorts were low, there was a significantly higher revision rate with NMCCKs. Given that cases requiring the use of NMCCK implants are likely more complex than those in which PS implants are used, our findings support the judicious use of NMCCK prostheses.

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“…THE JOURNAL OF BONE AND JOINT SURGERY Yoshii et al 23 described a series in which a press-fit in the diaphyseal medullary canal was achieved and reported a positive correlation between the length of the uncemented stem and its stability. These results were confirmed biomechanically by Conditt et al 24 in a dry-bone study.…”

Section: Discussionmentioning

confidence: 99%

Mid- to long-term results of revision total knee replacement using press-fit intramedullary stems with cemented femoral and tibial components

Manopoulos

Havet

Pearce

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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This was a retrospective analysis of the medium-to long-term results of 46 TC3 Sigma revision total knee replacements using long uncemented stems in press-fit mode.Clinical and radiological analysis took place pre-operatively, at two years post-operatively, and at a mean follow-up of 8.5 years (4 to 12). The mean pre-operative International Knee Society (IKS) clinical score was 42 points (0 to 74), improving to 83.7 (52 to 100) by the final follow-up. The mean IKS score for function improved from 34.3 points (0 to 80) to 64.2 (15 to 100) at the final follow-up. At the final follow-up 30 knees (65.2%) had an excellent result, seven (15.2%) a good result, one (2.2%) a medium and eight (17.4%) a poor result. There were two failures, one with anteroposterior instability and one with aseptic loosening.The TC3 revision knee system, when used with press-fit for long intramedullary stems and cemented femoral and tibial components, in both septic and aseptic revisions, results in a satisfactory clinical and radiological outcome, and has a good medium-to long-term survival rate.

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The effect of central stem and stem length on micromovement of the tibial tray

Cited by 59 publications

References 8 publications

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

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

Comparison of Revision Rates of Non-modular Constrained Versus Posterior Stabilized Total Knee Arthroplasty: a Propensity Score Matched Cohort Study

Mid- to long-term results of revision total knee replacement using press-fit intramedullary stems with cemented femoral and tibial components

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