The effect of total knee arthroplasty design on extensor mechanism function

Mahoney, Ormonde M.; McClung, Christian D.; Rosa, Mylene A dela; Schmalzried, Thomas P.

doi:10.1054/arth.2002.32168

Cited by 96 publications

(84 citation statements)

References 9 publications

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“…The Scorpio single radius total knee prosthesis was introduced in 1996 in an attempt to reduce concerns associated with other types of designs including patellar symptoms [9][10][11]. To the best of the authors' knowledge this is the first study on a consecutive series of patients evaluated after a minimal five-year follow-up following this particular single radius TKA including such a high number of patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, some concerns remain in relation to femoropatellar symptoms, anterior knee pain, patellar clunk, and backside wear [6][7][8]. Recently, an original design, based upon a single femoral radius has been introduced to improve the extensor mechanism function [9][10][11]. The aim of this retrospective study was to evaluate the minimal five-year follow-up clinical and radiological outcomes of the Scorpio (Stryker Orthopaedics, Mahwah, NJ) single radius total knee arthroplasty (TKA).…”

Section: Introductionmentioning

confidence: 99%

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Scorpio single radius total knee arthroplasty. A minimal five-year follow-up multicentric study

Borrione¹,

Bonnevialle

Mabit

et al. 2011

International Orthopaedics (SICOT)

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Purpose Our goal was to evaluate the five-year follow-up results of the Scorpio single radius total knee arthroplasty. Method We performed a retrospective study based upon a multicentre database to evaluate the minimum five-year follow-up clinical and radiological results of 747 patients (831 knees) who underwent primary Scorpio single radius total knee arthroplasty. Results The mean age of the patients was 71.9 years. At a minimal five-year follow-up, 141 patients were lost to follow-up, 83 patients had died, eight patients had undergone revision of a component, and the remaining 589 patients (602 knees) had a complete clinical and radiological evaluation after a median of six years (range, 5-8). The mean clinical component of the knee score was 92.2 points, and the mean functional component of the knee score was 76.9 points. At last follow-up, 530 of the 602 knees were rated as excellent or good. Only four knees developed patellar complications requiring revision. The survival rate at six years was 95.2%±1.9% and 98.3%±0.6 with revision for any reason and revision for mechanical failure as the end point, respectively. Conclusion This medium-term study indicates favourable clinical and radiological results for this single flexionextension radius design arthroplasty, with a low complication rate on the patellar side.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Scorpio single radius total knee arthroplasty. A minimal five-year follow-up multicentric study

Borrione¹,

Bonnevialle

Mabit

et al. 2011

International Orthopaedics (SICOT)

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“…[35][36][37][38][39] In Eastern and Middle Eastern countries, however, a greater degree of flexion is desired for activities such as squatting, kneeling, and sitting cross-legged that are important components of daily living. In Western populations, activities such as kneeling and gardening are also desirable but cannot always be achieved after TKA because of restricted knee flexion.…”

Section: Discussionmentioning

confidence: 99%

In vivo contact stresses during activities of daily living after knee arthroplasty

D’Lima

Steklov

Fregly

et al. 2008

Journal Orthopaedic Research

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ABSTRACT:We implanted an electronic knee prosthesis to measure tibial forces in vivo during activities of daily living after total knee arthroplasty. We used tibial forces and knee kinematic data collected in vivo to calculate contact stresses using finite element analysis. The polyethylene insert was modeled as an elastoplastic material, and predicted contact stresses were validated using pressure sensitive sensors. Peak contact stresses generated during walking were similar but about 18% lower than those calculated for International Standards Organization (ISO)-recommended wear simulation conditions. Stair climbing generated higher contact stresses (32 MPa) than walking (26 MPa). However, both high flexion activities (lunge and kneel) generated even higher contact stresses, with the lunge activity generating the highest stresses (56 MPa). The activities that generated high contact stresses also resulted in high equivalent plastic strain. However, the lunge activity generated dramatically higher plastic equivalent strain than the other activities. In vivo measurement of kinematics, forces, and contact stresses may be used to develop more clinically relevant wear simulator protocols. Contact stresses generated during high flexion activities were substantially higher and were largely due to the reduced contact area in deep flexion rather than due to an increase in contact forces. Our results support the use of ''high flexion'' designs that improve contact conditions and preserve contact area at high flexion angles. ß

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“…This design has been associated with improved extensor mechanism function and increased functional stability in posterior-stabilized designs [5,15,22,23]. Several features of this device, however, have been implicated as potential causes of early failure.…”

Section: Introductionmentioning

confidence: 99%

5- to 9-year Survivorship of Single-radius, Posterior-stabilized TKA

Mahoney

Kinsey

2008

Clinical Orthopaedics &Amp; Related Research

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We studied 1030 consecutive cemented primary TKAs performed by the primary author (OMM) using a single-radius, posterior-stabilized total knee prosthesis with 5 years' minimum followup to determine whether an accelerated early failure rate was associated with this design. At 5 to 9.5 postoperative years, 32 knees had been revised at an average of 2.4 postoperative years (range, 0.1-8.2 years) because of infection (11), periprosthetic fracture (10), aseptic loosening (eight), stiffness (two), and late hemarthrosis (one). Four had only the tibial insert revised. One-half of all failures occurred within 1.5 years. The cases of aseptic loosening involved the femoral component in one patient, tibial component in five, and both components in two. With only seven patients (0.7%) having unknown outcomes, the overall failure rate was 4.9 per 1000 person-years for the study period. The Kaplan-Meier survivorship using any part of the prosthesis removed or revised for any reason as the end point was 95.8% (95% confidence interval, 93.7%-95.5%), and with aseptic loosening as the end point, it was 98.6% (95% confidence interval, 96.5%-99.4%). The midterm survivorship rates were comparable to those of other posterior-stabilized total condylar designs and are not suggestive of excessive risk of early failure.

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The effect of total knee arthroplasty design on extensor mechanism function

Cited by 96 publications

References 9 publications

Scorpio single radius total knee arthroplasty. A minimal five-year follow-up multicentric study

Scorpio single radius total knee arthroplasty. A minimal five-year follow-up multicentric study

In vivo contact stresses during activities of daily living after knee arthroplasty

5- to 9-year Survivorship of Single-radius, Posterior-stabilized TKA

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