scholarly journals Clinical radiographic outcomes and survivorship of medial pivot design total knee arthroplasty: a systematic review of the literature

2021 ◽  
Author(s):  
Mattia Alessio-Mazzola ◽  
Antonio Clemente ◽  
Antonio Russo ◽  
Peter Mertens ◽  
Giorgio Burastero ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Rate ◽  
Analysis Data ◽  
Systematic Research ◽  
Radiographic Outcomes ◽  
Patient Reported ◽  
Medial Pivot ◽  
Total Knee

Abstract Background Total knee arthroplasty is a reliable procedure able to reduce pain and disability in patients suffering from osteoarthritis. However, a considerable percentage of patients still experiences unsatisfactory results. Medial pivot total knee arthroplasty has been introduced in the clinical practice to overcome problems related with classic design implants and better mimic native knee kinematics. The aim of this study was to analyze survivorship and clinical and radiographic outcomes of medial pivot implants. Methods A systematic research was conducted in eight different databases. Thirty-four studies met the inclusion criteria and were included in the analysis. Data on objective and patients-reported outcomes, radiographic alignment, and survivorship were collected and analyzed. Revision rate was expressed as revision per 100 components years. Result A total of 3377 procedures were included. Mean follow-up was 85.7 months (range, 12–182). The revision per 100 components years was 0.19, which corresponds to a revision rate of 1.9% after 10 years. Mean post-operative range of motion was 117.3 ± 0.4°. Mean clinical and functional Knee Society Score were, respectively, 85.9 ± 1.1 and 84.7 ± 3.5 at final follow-up. Post-operative femorotibial alignment was 177.1 ± 0.5°. Alfa and beta angles were 95.7 ± 0.1° and 89.2 ± 0.1°, respectively. Gamma and delta angles were 2.3 ± 0.6° and 86.7 ± 0.4°. Conclusion Medial pivoting implants provided excellent survivorship and low revision rate, as well as good-to-excellent results in term of objective and patient-reported clinical outcomes, and reliable correction of radiographic parameters. More high-quality studies with long-term follow-up are needed to clarify the role of medial pivoting implants.

scholarly journals Outcomes of the rotating hinge knee in revision total knee arthroplasty with a median follow-up of 6.2 years

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jake von Hintze ◽  
Mika Niemeläinen ◽  
Harri Sintonen ◽  
Jyrki Nieminen ◽  
Antti Eskelinen
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Survival Rate ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Patient Reported ◽  
Total Knee ◽  
Revision Tka

Abstract Background The purpose of this study was to determine the mid-term clinical, radiographic and health-related quality of life (HRQoL) outcomes and define the survival rate in patients who had undergone revision total knee arthroplasty (TKA) using the single rotating hinged knee (RHK) design. Methods Between January 2004 and December 2013, 125 revision TKAs were performed at our institution using the single RHK implant. We conducted both a retrospective analysis of prospectively collected outcome data of these patients and a prospective follow-up study of all 39 living patients (41 knees). The follow-up phase included an optional extra follow-up visit, PROM questionnaires, and plain radiographs. Results The ten-year Kaplan-Meier survival rate of the revision RHK knees was 81.7% (95% CI 71.9–91.6%) with re-revision for any reason as the endpoint. Overall, 15 knees (12% of the total) underwent re-revision surgery during the follow-up. The median follow-up was 6.2 years (range, 0–12.7 years) post-operatively for the baseline group. One mechanical hinge mechanism-related failure occurred without any history of trauma or infection. At the time of the final follow-up, the majority of patients evinced a fairly good clinical outcome measured with patient-reported outcome measures and none of the components were radiographically loose. Conclusion We found that in patients undergoing complex revision TKA, fairly good functional outcome and quality of life can be achieved using an RHK implant. Further, it seems that in this type of patient cohort, revision TKA using an RHK implant relieves pain more than it improves ability to function. The NexGen® RHK design can be regarded as a suitable option in complex revision TKA.

Midterm results of a new personalized knee implant for total knee arthroplasty: implant survivorship and patient-reported outcome after five years’ follow-up

2021 ◽  
Author(s):  
Cristina Dauder Gallego ◽  
Irene Blanca Moreno Fenoll ◽  
José Luis Patiño Contreras ◽  
Francisco Javier Moreno Coronas ◽  
María del Carmen Torrejón de la Cal ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patient Reported Outcome ◽  
Midterm Results ◽  
Implant Survivorship ◽  
Patient Reported ◽  
Total Knee

scholarly journals High usage of medial unicompartmental knee arthroplasty negatively influences total knee arthroplasty revision rate

2021 ◽  
Author(s):  
Antonio Klasan ◽  
Mei Lin Tay ◽  
Chris Frampton ◽  
Simon William Young
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Revision Rate ◽  
Oxford Knee Score ◽  
High Volume ◽  
Unicompartmental Knee ◽  
Patient Reported ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Total Knee

Abstract Purpose Surgeons with higher medial unicompartmental knee arthroplasty (UKA) usage have lower UKA revision rates. However, an increase in UKA usage may cause a decrease of total knee arthroplasty (TKA) usage. The purpose of this study was to investigate the influence of UKA usage on revision rates and patient-reported outcomes (PROMs) of UKA, TKA, and combined UKA + TKA results. Methods Using the New Zealand Registry Database, surgeons were divided into six groups based on their medial UKA usage: < 1%, 1–5%, 5–10%, 10–20%, 20–30% and > 30%. A comparison of UKA, TKA and UKA + TKA revision rates and PROMs using the Oxford Knee Score (OKS) was performed. Results A total of 91,895 knee arthroplasties were identified, of which 8,271 were UKA (9.0%). Surgeons with higher UKA usage had lower UKA revision rates, but higher TKA revision rates. The lowest TKA and combined UKA + TKA revision rates were observed for surgeons performing 1–5% UKA, compared to the highest TKA and UKA + TKA revision rates which were seen for surgeons using > 30% UKA (p < 0.001 TKA; p < 0.001 UKA + TKA). No clinically important differences in UKA + TKA OKS scores were seen between UKA usage groups at 6 months, 5 years, or 10 years. Conclusion Surgeons with higher medial UKA usage have lower UKA revision rates; however, this comes at the cost of a higher combined UKA + TKA revision rate that is proportionate to the UKA usage. There was no difference in TKA + UKA OKS scores between UKA usage groups. A small increase in TKA revision rate was observed for high-volume UKA users (> 30%), when compared to other UKA usage clusters. A significant decrease in UKA revision rate observed in high-volume UKA surgeons offsets the slight increase in TKA revision rate, suggesting that UKA should be performed by specialist UKA surgeons. Level of evidence III, Retrospective therapeutic study.

scholarly journals Double-high insert presents with worse mid-term outcomes in cruciate-retaining medial-pivotal total knee arthroplasty – a propensity score matched analysis with averaged 8-year follow-up

2021 ◽  
Author(s):  
Shuai Xiang ◽  
Yingzhen Wang ◽  
Chengyu Lv ◽  
Changyao Wang ◽  
Haining Zhang
Keyword(s):  
Total Knee Arthroplasty ◽  
Propensity Score ◽  
Knee Arthroplasty ◽  
Womac Score ◽  
Cruciate Retaining ◽  
Radiographic Outcomes ◽  
Clinical Scores ◽  
Total Knee ◽  
Knee Society Function Score

Abstract Background The aim of this study was to compare the mid-term clinical and radiographic outcomes between medial-pivotal (MP) insert and double-high (DH) insert used under cruciate-retaining condition in ADVANCE® total knee arthroplasty (TKA). Methods The follow-up was conducted for 158 consecutive patients underwent unilateral ADVANCE® TKA from January 2011 to April 2014. 84 MP inserts and 74 DH inserts were used under cruciate-retaining condition. A 1:1 propensity score matching (PSM) analysis was performed between MP insert and DH insert to compare the clinical and radiographic outcomes. Results After a 1:1 PSM, 120 patients (60 pairs) were matched between MP insert and DH insert. The baseline demographic parameters and clinical scores were comparable between the two groups. The postoperative clinical outcomes at an averaged 8-year follow-up of both groups were significantly improved. The range of motion (ROM) of DH group was better than that of MP group and equivalent Knee Society Function Score (KSFS) between the two groups was found. However, the Knee Society Score (KSS), Western Ontario and McMaster Universities Arthritis Index (WOMAC) score and Forgotten Joint Score (FJS) of MP group were found to be significantly superior than those of DH group. Comparable complication rate and revision rate were observed between the two groups. The radiographic results were also equally good between MP and DH group. Conclusions Although the mid-term clinical and radiographic outcomes of DH insert are fairly good, the clinical scores of DH group were worse than those of MP group.

No differences in patient-reported outcomes between medial pivot insert and symmetrical insert in total knee arthroplasty: A randomized analysis

The Knee ◽  
2018 ◽  
Vol 25 (6) ◽  
pp. 1254-1261 ◽  
Author(s):  
Kohei Nishitani ◽  
Moritoshi Furu ◽  
Shinichiro Nakamura ◽  
Shinichi Kuriyama ◽  
Masahiro Ishikawa ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patient Reported Outcomes ◽  
Patient Reported ◽  
Medial Pivot ◽  
Total Knee

scholarly journals Total knee arthroplasty with the Medial-Pivot knee system: Clinical and radiological outcomes at 9.5 years’ mean follow-up

2018 ◽  
Vol 104 (2) ◽  
pp. 185-191 ◽  
Author(s):  
M. Dehl ◽  
Y. Bulaïd ◽  
M. Chelli ◽  
R. Belhaouane ◽  
A. Gabrion ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Medial Pivot ◽  
Total Knee

scholarly journals Complications of Patella in Total Knee Arthroplasty (TKA)

2021 ◽  
Vol 6 (5) ◽  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patellar Instability ◽  
Revision Rate ◽  
Functional Limitation ◽  
Patellofemoral Instability ◽  
Mobile Bearing ◽  
Extensor Mechanism ◽  
Total Knee

Background and Methods: Postoperative complications may impair the outcome of total knee arthroplasty (TKA). Patellar instability is a major cause of postoperative pain and functional limitation for which revision surgery may be necessary [1]. It may occur after TKA with or without patellar resurfacing. RESULTS AND CONCLUSIONS: Subluxation is more common than dislocation; the incidence of symptomatic instability leading to revision is low (0.5 to 0.8%) [2, 3]. In a multicentre study of low contact stress mobile bearing TKAs, only 6 of 259 revisions were associated with patellar instability, which accounted for a revision rate of 0.1% after a mean follow-up duration of 5.7 years [4]. A revision rate of 12% was reported secondary to complications of the extensor mechanism [5]. The aetiology of patellofemoral instability can be related to (1) the surgical technique and component positioning, (2) extensor mechanism imbalance, and (3) other causes.

scholarly journals 1-Year Patient Outcomes for Robotic-Arm Assisted vs. Manual Total Knee Arthroplasty

10.29007/nrl3 ◽  
2019 ◽  
Author(s):  
Robert Marchand ◽  
Nipun Sodhi ◽  
Hiba Anis ◽  
Joseph Ehiorobo ◽  
Jared Newman ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Linear Regression ◽  
Physical Function ◽  
Knee Arthroplasty ◽  
Robotic Arm ◽  
Pain Scores ◽  
Patient Reported ◽  
Beta Coefficient ◽  
Total Knee

Introduction:Robotic-arm assisted (RAA) total knee arthroplasty (TKA) has been shown to potentially have certain pre- and intra-operative advantages over manual techniques. Although there are many studies on the alignment advantages when using the robotic-arm assisted (RAA) system for total knee arthroplasty (TKA), there have been questions regarding patient-reported outcomes. Therefore, the purpose of this study was to use this index to compare: 1) total; 2) physical function; and 3) pain scores for manual vs. RAA patients.Methods:We compared 53 consecutive robotic-arm assisted to 53 consecutive manual TKAs. No differences in pre-operative scores were found between the cohorts. Patients were administered a modified WOMAC satisfaction survey pre-operatively, and at 1-year post-operatively. Univariate analyses and multivariate models with stepwise backward linear regression were utilized to evaluate the associations between outcome scores and surgical technique, age, sex, as well as body mass index (BMI).Results:The RAA cohort had significantly improved mean total (6±6 vs. 9±8 points, p=0.03) and physical function scores (4±4 vs. 6±5 points, p=0.02) when compared to the manual cohort. The mean pain score for the RAA cohort [2±3 points (range, 0 to 14 points)], was also lower than that for the manual cohort [3±4 points (range, 0 to 11 points) (p=0.06)].On backward linear regression analyses, RAA was found to be significantly associated with more improved total (beta coefficient [β]-0.208, SE [standard error] 1.401, p&lt;0.05), function (β=0.216, SE=0.829, p&lt;0.05), and pain scores (β-0.181, SE=0.623, p=0.063). The RAA technique was found to have the strongest association with improved scores.Conclusion:With newer surgical technologies constantly being introduced, it is imperative to continue to evaluate these new modalities, particularly in their abilities to improve patient satisfaction outcomes. This study suggests that RAA patients may have short term improvements at minimum 1-year post-operative. However, longer-term follow up with greater sample sizes are needed to further validate these findings.

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