The New Arthritic Patient and Arthroplasty Treatment Options

Argenson, Jean-Noël; Parratte, Sébastien; Bertani, Antoine; Aubaniac, Jean-Manuel; Lombardi, Adolph V.; Berend, Keith R.; Adams, Joanne B.; Lonner, Jess H.; Mahoney, Ormonde M.; Kinsey, Tracy L.; John, Thomas K.; Conditt, Michael A.

doi:10.2106/jbjs.i.00406

Cited by 44 publications

(12 citation statements)

References 3 publications

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“…For arthritic patients with 20–40 years remaining life expectancy, reliable long-term follow-up data on TKA are a sound basis for decision making. Therefore, studies on longer-term follow-up after TKA performed in the past decade [7, 9–18] deserve further attention, despite the logistic problems and limitations. Besides, reliable long-term data on implants still in use can serve to evaluate quality and performance of new devices.…”

Section: Introductionmentioning

confidence: 99%

Total knee arthroplasty at 15–17 years: Does implant design affect outcome?

Victor

Ghijselings²,

Tajdar³

et al. 2013

International Orthopaedics (SICOT)

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PurposeA study was conducted to compare minimum 15-year survivorship and outcome of the Genesis I and II implants for total knee arthroplasty (TKA).MethodsWe retrospectively reviewed 245 consecutive TKA implanted between January 1995 and October 1997. Genesis I was implanted in 156 knees and Genesis II in 89 knees.ResultsAt 15–17 years, 75 patients (31 %) had died, 28 patients (11 %) were lost to follow-up and 11 TKA were revised (4.6 %), including ten Genesis I (6.4 %) and one Genesis II (1.1 %); 131 TKA (53 %) were available for follow-up. Cumulative survivorship was 92.4 % at 15.7 years. Survival in patients <69 years at surgery was lower (88.0 %) compared with patients ≥69 years (98.5 %; p = 0.023). In patients <69 years, Genesis I survival (84.3 %) was worse compared with Genesis II (97.1 %) (p = 0.018). Polyethylene (PE) Insert thickness ≤11 mm had significantly better survivorship (97.1 %) compared with PE >11 mm (56.7 %) (p < 0.0001)ConclusionsAt a minimum of 15 years, the overall (92.4 %) survivorship of Genesis TKA was good, with excellent (98.1 %) survivorship of the Genesis II design. Revision rates were higher with Genesis I in the younger age group and with insert thickness >11 mm, possibly due to longer shelf life of less frequently used sizes.

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Section: Introductionmentioning

confidence: 99%

Total knee arthroplasty at 15–17 years: Does implant design affect outcome?

Victor

Ghijselings²,

Tajdar³

et al. 2013

International Orthopaedics (SICOT)

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“…Separate components for the medial side, lateral side, and patello-femoral joint can be selected depending on the specific cases. This has been successfully practised by Aubaniac and Associates in Marseilles for more than 10 years and may receive greater attention in the future [80].…”

Section: Figmentioning

confidence: 99%

Future directions in knee replacement

Walker

Yildirim

Arno

et al. 2009

Proc Inst Mech Eng H

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The use of artificial joints for the treatment of osteoarthritis is expected to expand considerably over the next decade. While newer technologies can offer yet further improvements in total knee systems, implementation will be strongly affected by the need to satisfy apparently competing requirements. Patients expect quicker rehabilitation, improved performance, and lifelong durability; on the other hand, economic constraints require a reduction in cost for each procedure, as well as early intervention and preventative measures, while there is increased pressure from health care systems to use evidence-based medicine as the standard of choice for implants and techniques. The success of a knee replacement depends on the design itself, the surgical technique, the rehabilitation, and, not least, the patient. The major goal of the implant design can be redefined as a restoration of normal knee mechanics, whether by maximum preservation of tissues, or by guiding surfaces that replace their function. Surgical technique needs to be less invasive but achieve optimal patient-specific alignment and soft tissue balancing. Rehabilitation procedures must achieve the expectations of realistic patients. Testing and evaluation methods need to be upgraded for enhanced predictability. This paper discusses current trends and future possibilities to address this expansive scope of design criteria.

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Section: Introductionmentioning

confidence: 99%

“…Currently, the primarily surgical methods of treating unicompartmental knee arthritis include high tibial osteotomy, unicompartmental knee arthroplasty (UKA) and conventional total knee arthroplasty (TKA). 1 However, with the increasing concerns regarding the finite life span and post-operative functional recovery of these aforementioned procedures, the indications for UKA in the treatment of medial osteoarthritis were expanded. 2 Moreover, many studies have reported excellent clinical outcomes after UKA, including the reduction of post-operative pain, the correction of angle deformity, the return of range of motion (ROM) and the improvement of clinical and functional scores.…”

Section: Introductionmentioning

confidence: 99%