The radiological assessment of total and unicompartmental knee replacements

Sarmah, SS; Patel, Shelain; Hossain, Fahad S; Haddad, Fares S.

doi:10.1302/0301-620x.94b10.29411

Cited by 62 publications

(42 citation statements)

References 93 publications

(81 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This has a reported kappa value for interobserver error for TKA of 0.781 [22]. Subsidence was defined as angulation or subsidence greater than 2 mm from the postoperative position with implant position defined according to criteria summarized by Sarmah et al [23].…”

Section: Methodsmentioning

confidence: 99%

Proximal Tibial Bone Density Is Preserved After Unicompartmental Knee Arthroplasty

Richmond

Hadlow

Lynskey

et al. 2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Bone mineral density (BMD) in the proximal tibia decreases after TKA and is believed to be a factor in implant migration and loosening. Unicompartmental knee arthroplasty (UKA) is a less invasive procedure preserving knee compartments unaffected by degeneration. Finite element studies have suggested UKA may preserve BMD and that implants of differing stiffnesses might differentially affect BMD but these notions have not been clinically confirmed. Questions/purposes We therefore asked whether (1) proximal tibial BMD decreases after UKA, and (2) a cemented metal tibial component with a mobile polyethylene (PE) bearing would have greater BMD loss than a cemented PE tibial component. Methods We prospectively followed 48 patients who underwent 50 UKAs using one of two implants: one with a cemented metal tibial baseplate and a mobile PE insert (n = 26) and one with a cemented all-PE tibial component (n = 24). In followup we assessed pain and function (Oxford Knee Score, SF-12, The Knee Society Score Ó ) and radiographs. BMD changes were assessed using quantitative CT osteodensitometry performed postoperatively and at 1 and 2 years after the index procedure. Results Mean cancellous BMD decreased 1.9% on the medial side and 1.1% on the lateral side. Mean cortical BMD was static, decreasing 0.4% on the medial side and increasing 0.5% on the lateral side. The greatest observed difference between implants for any region was 3.7%. There were no differences in pain or functional outcome scores. Conclusions BMD was preserved 2 years after UKA with no major differences seen between implant types.

show abstract

Section: Methodsmentioning

confidence: 99%

Proximal Tibial Bone Density Is Preserved After Unicompartmental Knee Arthroplasty

Richmond

Hadlow

Lynskey

et al. 2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Plain radiographs are the most commonly used modality determining alignment of the components, although gold standard is 3D-CT [14, 25]. We used the “Knee Society total knee arthroplasty radiological evaluation and scoring system” [8] which is an accepted tool for radiological analysis [1, 25].…”

Section: Discussionmentioning

confidence: 99%

“…We used the “Knee Society total knee arthroplasty radiological evaluation and scoring system” [8] which is an accepted tool for radiological analysis [1, 25]. Restoration of alignment is thought to play an important role in improving survival of TKA [23] and functional outcome [4, 19]; thus we focused our radiological analysis on TKA with a minimum follow-up of more than ten years.…”

Section: Discussionmentioning

confidence: 99%

Long-term survival and radiological results of the Duracon™ total knee arthroplasty

Bachmann

Bolliger

Ilchmann

et al. 2013

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

PurposeThe aim of this study was to analyse the long-term (>ten years) survival rate and radiological results of the Duracon TKA.MethodsBetween 1992 and 1999 159 Duracon TKA were implanted at our institution. A Kaplan-Meier survival analysis for the endpoints exchange, addition or removal of any component for any reason, revision due to aseptic loosening and mechanical failure was performed. Radiological long-term (>ten years) follow-up (FU) analysis was performed according to the Knee Society Radiographic Evaluation and Scoring System.ResultsMean age at surgery was 74.3 years, 28 % were male, and 89 % had primary osteoarthritis as diagnosis. Mean FU for survival analysis was 10.9 years (SD 4.2). A total of 58 % of the patients died during follow-up. Three patients (2.1 %) were lost to follow-up and five TKA (3.1 %) were revised. After ten years the mean survival was 97.7 %, 99.4 % and 98.3 % for the aforementioned endpoints, respectively. Mean radiological FU was 11.8 years (SD 2.3). We found no significant change in alignment of the components or axis over time. Progressive radiolucencies were found in nine TKA (17 %), mainly around the tibial component (95 %).ConclusionThe Duracon TKA showed excellent long-term survival comparable to data from national registers and to other successful designs. Radiological changes found on plain radiographs were scarce after almost 12 years of radiological follow-up indicating good implant stability.

show abstract

“…Radiological assessments were performed at the same time as the clinical assessments using by AP radiography in a standing position (except for the supine position radiography which was taken immediately after surgery) and lateral view using the radiological evaluation system of the Knee Society [31,32]. The degree of malalignment was measured using the mechanical tibiofemoral axis (same as hip-knee-ankle (HKA) axis).…”

Section: Radiological Assessmentsmentioning

confidence: 99%

“…However, a pathological RLL was >2 mm thick and had a poorly de ned progression [30]. The position of the zones was used to describe the location of the radiolucencies followed by the Knee Society total knee replacement radiological assessment of the radiolucent lines [31,32]. It was related to aseptic implant loosening [30,34].…”

Section: Radiological Assessmentsmentioning

confidence: 99%

Early Clinical and Radiological outcomes of the New Anatomic Knee System : Minimum 3-year Follow-up.

Ryu

Jeon

Shin³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: For total knee arthroplasty (TKA), implant design and proper coverage are important for achieving patient satisfaction. An asymmetrical anatomic implant (Persona® knee system, Zimmer Biomet, Warsaw, Indiana) enables accurate coverage and minimal bone cutting. This study aimed to analyze the clinical and radiological outcomes of TKA using an asymmetrical anatomic implant over a minimum 3-year follow-up.Methods: The medical records of 94 patients who underwent 132 TKAs using the Persona® knee system, between April 2015 and January 2016 were reviewed. Pre- and post-operative clinical outcomes (assessed using the International Knee Documentation Committee (IKDC), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores, and range of motion (ROM) were reviewed. The mechanical hip-knee-ankle (HKA) axis, component overhang and underhang and presence of a radiolucent line (RLL) were evaluated. Liner thickness were also reviewed.Results: At 3-year follow-up, the mean ROM improved from 108.4° to 130.3°. The mean IKDC subjective, WOMAC and global KOOS score significantly improved from 29.2 to 70.3, from 64.2 to 11.5, and from 66.6 to 21.7, respectively (p<0.0001). The mean mechanical HKA axis indicated the correction of the malalignment (from 9.2° varus to 0.3° varus, p<0.001). The incidence rates of >3-mm bone-to-implant size mismatch were 6.8% and 8.3% for the femoral and tibial components, respectively. RLL was found in seven cases, but they were small (>2 mm) and did not progress. In 36.3% of the knees, the additional liner thickness (11 or 13mm) was used. No case of implant loosening or early failure related to the implant design occurred. Conclusion: TKA using the Persona® knee system improved all the clinical knee scores and ROM without signs of early failure. This knee system also provides more implant size options than the conventional TKA systems and facilitates ligament balancing.

show abstract

The radiological assessment of total and unicompartmental knee replacements

Cited by 62 publications

References 93 publications

Proximal Tibial Bone Density Is Preserved After Unicompartmental Knee Arthroplasty

Proximal Tibial Bone Density Is Preserved After Unicompartmental Knee Arthroplasty

Long-term survival and radiological results of the Duracon™ total knee arthroplasty

Early Clinical and Radiological outcomes of the New Anatomic Knee System : Minimum 3-year Follow-up.

Contact Info

Product

Resources

About

The radiological assessment of total and unicompartmental knee replacements

Cited by 62 publications

References 93 publications

Proximal Tibial Bone Density Is Preserved After Unicompartmental Knee Arthroplasty

Proximal Tibial Bone Density Is Preserved After Unicompartmental Knee Arthroplasty

Long-term survival and radiological results of the Duracon™ total knee arthroplasty

Early Clinical and Radiological outcomes of&nbsp;the New Anatomic Knee System : Minimum 3-year Follow-up.

Contact Info

Product

Resources

About

Early Clinical and Radiological outcomes of the New Anatomic Knee System : Minimum 3-year Follow-up.