scholarly journals A Retrospective Comparison of a Medial Pivot and Posterior-Stabilized Total Knee Arthroplasty With Respect to Patient-Reported and Radiographic Outcomes

2018 ◽  
Vol 33 (5) ◽  
pp. 1379-1383 ◽  
Author(s):  
David A. Samy ◽  
Jesse I. Wolfstadt ◽  
Iman Vaidee ◽  
David J. Backstein
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Posterior Stabilized ◽  
Radiographic Outcomes ◽  
Retrospective Comparison ◽  
Patient Reported ◽  
Medial Pivot ◽  
Total Knee

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.

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 No Difference in Recovery of Patient-Reported Outcome and Range of Motion between Cruciate Retaining and Posterior Stabilized Total Knee Arthroplasty: A Double-Blind Randomized Controlled Trial

2019 ◽  
Vol 33 (12) ◽  
pp. 1243-1250
Author(s):  
Lennard G. H. van den Boom ◽  
Reinoud W. Brouwer ◽  
Inge van den Akker-Scheek ◽  
Inge H. F. Reininga ◽  
Astrid J. de Vries ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Patient Reported Outcome ◽  
Secondary Outcome ◽  
P Value ◽  
Posterior Stabilized ◽  
Double Blind ◽  
Patient Reported ◽  
Total Knee

AbstractBoth from the perspective of the individual and from a socioeconomic point of view (e.g., return to work), it is important to have an insight into the potential differences in recovery between posterior cruciate ligament retaining (PCR) and posterior stabilized (PS) total knee arthroplasty (TKA) implants. The primary aim of this study was to compare the speed of recovery of patient-reported outcome between patients with a PCR and PS TKA during the first postoperative year. The secondary aim was to compare the effect on range of motion (ROM). In a randomized, double-blind, controlled, single-center trial, 120 adults diagnosed with osteoarthritis of the knee were randomized into either the PCR or PS group. Primary outcome was speed of recovery of patient-reported pain and function, measured with the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), with a follow-up of 1 year. Main secondary outcome measure was ROM. A generalized estimating equations (GEE) analysis was used to assess whether there was a difference over time between groups (“p-value for interaction”). Between 2008 and 2011, 59 participants received a PCR TKA (mean age, 70.3 years [SD = 7.7]; mean body mass index [BMI], 30.5 kg/m2 [SD = 5.4]) and 55 participants a PS TKA (mean age, 73.5 years [SD = 7.0]; mean BMI, 29.2 kg/m2 [SD = 4.4]). Six patients (two PCR and four PS) were excluded because of early drop-out, so 114 patients (95%) were available for analysis. In between group difference for total WOMAC score was −1.3 (95% confidence interval [CI]: −5.6 to 3.1); p-value for interaction was 0.698. For ROM, in between group difference was 1.1 (95% CI: −2.6 to 4.7); p-value for interaction was 0.379. These results demonstrated that there are no differences in speed of recovery of WOMAC or ROM during the first postoperative year after PCR or PS TKA.

J-curve design total knee arthroplasty: the posterior stabilized shows wider medial pivot compared to the cruciate retaining during chair raising

2019 ◽  
Vol 28 (9) ◽  
pp. 2883-2892 ◽  
Author(s):  
Marco Bontempi ◽  
Tommaso Roberti di Sarsina ◽  
Giulio Maria Marcheggiani Muccioli ◽  
Nicola Pizza ◽  
Umberto Cardinale ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Posterior Stabilized ◽  
Cruciate Retaining ◽  
Curve Design ◽  
J Curve ◽  
Medial Pivot ◽  
Total Knee

Intraoperative Medial Pivot Affects Deep Knee Flexion Angle and Patient-Reported Outcomes After Total Knee Arthroplasty

2014 ◽  
Vol 29 (4) ◽  
pp. 702-706 ◽  
Author(s):  
Yusuke Nishio ◽  
Tomohiro Onodera ◽  
Yasuhiko Kasahara ◽  
Daisuke Takahashi ◽  
Norimasa Iwasaki ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Patient Reported Outcomes ◽  
Flexion Angle ◽  
Knee Flexion Angle ◽  
Patient Reported ◽  
Medial Pivot ◽  
Total Knee

scholarly journals Revision Total Knee Arthroplasty With the Use of Restricted Kinematic Alignment Protocol: Surgical Technique and Initial Results

2021 ◽  
Vol 8 ◽  
Author(s):  
Lazaros Kostretzis ◽  
Gabriel Bouchard Roby ◽  
Sagi Martinov ◽  
Marc-Olivier Kiss ◽  
Janie Barry ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Adverse Events ◽  
Knee Arthroplasty ◽  
Womac Score ◽  
Kinematic Alignment ◽  
Posterior Stabilized ◽  
Patient Reported ◽  
Total Knee ◽  
Revision Tka

Purpose: Kinematic alignment (KA) for primary total knee arthroplasty (TKA) has been shown to provide equivalent or better results to mechanical alignment (MA). The use of KA in revision TKA to restore the individual knee anatomy, kinematics, and soft-tissue balance, has not been documented yet. The purpose of this study is to describe the technique for performing TKA revision using the restricted KA (rKA) protocol and to report (1) rerevision rate and adverse events, (2) patient-reported outcome measures (PROMs), and (3) radiological signs of implant dysfunction related to this technique.Methods: The rKA protocol was used in 43 selected TKA revisions cases suitable for the technique. Adverse events, reoperation, revision, and their causes were recorded. In addition, PROMs assessed by WOMAC score and radiographic evaluation to identify signs of implant dysfunction were documented at last follow-up.Results: After a mean follow-up of 4.0 years (0.9–7.7, ±2), only one rerevision (2.3%) was required for persisting instability (polyethylene liner exchange from posterior stabilized to a semi-constrained). Short-cemented stems were used for both the femur and tibia in 28 (65%) cases, for the femur alone in 13 (30%) cases, and no stems in two cases. In 31 (72%) cases, a standard posterior stabilized tibial insert was used, while 12 (28%) cases required a semi-constrained insert. The mean WOMAC score was 34.4 (0–80, ±21.7). Mean postoperative arithmetic hip-knee-ankle angle (HKA) was 0.8° varus (from 5° varus to 4° valgus), mean mechanical distal femoral angle was 1.7° valgus (from 2° varus to 5° valgus), and mean mechanical tibia proximal angle was 2.2° varus (from 5° varus to 1° valgus). No radiological evidence of aseptic loosening or periprosthetic radiolucencies were identified.Conclusion: Although current revision TKA implants are not ideal for revision TKA performed with rKA, they are an appealing alternative to MA, especially in cases of early, non-wear-related, unsuccessful MA TKAs. rKA TKA revision using short-cemented stems in conjunction with meticulous preoperative planning is safe in the mid-term.Level of evidence: IV

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