Does the Use of Intraoperative Pressure Sensors for Knee Balancing in Total Knee Arthroplasty Improve Clinical Outcomes? A Comparative Study With a Minimum Two-Year Follow-Up

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

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Cementless Tritanium Baseplate Total Knee Arthroplasty: Survivorship and Outcomes at 5-Year Minimum Follow-Up

The Journal of Knee Surgery ◽

10.1055/s-0040-1712983 ◽

2020 ◽

Vol 33 (09) ◽

pp. 862-865

Author(s):

John M. Tarazi ◽

Hytham S. Salem ◽

Joseph O. Ehiorobo ◽

Nipun Sodhi ◽

Michael A. Mont ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Porous Titanium ◽

Septic Loosening ◽

Cement Interface ◽

Implant Survivorship ◽

Total Knee ◽

Highly Porous

Abstract Background Newer generation cementless total knee arthroplasty (TKA) designs have provided stronger osteointegration between the implant and bone. Despite excellent survivorship and outcomes with cemented TKAs, areas of concern within the bone–cement interface remain a concern and necessitate studies on alternative constructs. This study assesses: (1) implant survivorship; (2) clinical outcomes; and (3) complications with radiographic outcomes at a 5-year minimum follow-up of cementless highly porous titanium-coated baseplates in TKAs. Methods Part of this study has been reported. We retrospectively reviewed a prospectively collected database at a single high-volume institution between July 1, 2013 and June 30, 2014 for patients who underwent a primary TKA using cementless highly porous titanium-coated baseplate implants. Patients were evaluated clinically at postoperative follow-up visits at a minimum of 5 years. To calculate the survivorship, Kaplan–Meier analysis was performed to determine all-cause, aseptic, and septic implant survivorship at each final follow-up for all patients. Results A total of 228 TKAs were performed and followed for a minimum of 5 years (range, 5–6 years). As of the latest follow-up, one case of septic loosening of the patellar button and one case of patellar dislodgment secondary to physical manipulation were recorded and revised. Overall, the cohort displayed implant survivorship of 99.5% at 5-year minimum follow-up. Improvements were seen in both Knee Society pain and function scores and were 37 points (range, 17–60 points) and 28 points (range, 15–47 points), respectively. The mean improvement in flexion was 17.8 (range, –20 to 40 degrees) and mean improvement in extension was –5.5 (range, –30 to 5 degrees). Discussion Cementless TKAs serve as strong alternative choice to cemented TKAs. Although cemented fixation is commonly known as the gold standard, results of this study confirm the findings of previous investigations on the survivorship of cementless TKA implants. Therefore, patients who undergo primary TKA with a cementless tritanium baseplate can expect excellent clinical outcomes at a 5-year minimum follow-up.

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Partial versus Intact Posterior Cruciate Ligament-retaining Total Knee Arthroplasty: A Comparative Study of Early Clinical Outcomes

Orthopaedic Surgery ◽

10.1111/os.12269 ◽

2016 ◽

Vol 8 (3) ◽

pp. 331-337 ◽

Cited By ~ 3

Author(s):

Bo Zhang ◽

Cheng-kung Cheng ◽

Tie-Bing Qu ◽

Yong Hai ◽

Yuan Lin ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Comparative Study ◽

Posterior Cruciate Ligament ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Cruciate Ligament ◽

Posterior Cruciate Ligament Retaining ◽

Total Knee ◽

Early Clinical Outcomes

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Long-term follow up of Navigation TKA using multi directional mobile bearing design

10.29007/3724 ◽

2018 ◽

Author(s):

Eun-Kyoo Song ◽

Jong-Keun Seon ◽

Dong-Hyun Lee ◽

Je-Hyoung Yeo

Keyword(s):

Total Knee Arthroplasty ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Survival Rates ◽

Mobile Bearing ◽

Long Term Follow Up ◽

Total Knee ◽

Bearing Design

Total knee arthroplasty using navigation system is known to be more effective than conventional methods in achieving more accurate bone resection and neutral alignment.1 Mobile bearing is also known to reduce wear and automatically correct rotational malalignment of the tibia but the long-term follow-up results of more than 10 years are extremely rare.2, 3 The purpose of this study is to investigate the results of clinical and radiologic long-term follow-up and complications of total knee arthroplasty using navigation and multi-directional mobile bearing.From 2003 to 2006, a total of 111 navigation TKAs using multi-directional mobile bearing design were carried out and reviewed retrospectively. TKAs were performed by two experienced surgeons at one institute. Of the 111 patients, 102 were women and 9 were men. The mean duration of follow-up was 11.4 ± 1.0 years (range, 10.1 to 14.08 years). Clinical outcomes were evaluated in terms of Knee Society Score, Hospital for Special Surgery score, Western Ontario and McMaster University (WOMAC) score, range of motion and complications. Long-term radiological outcomes and survival rates were evaluated at least 10 years.Average preoperative HSS score was 66.5 ± 9.8 and KSS pain and function score were 25.0 ± 11.8 and 44.5 ± 12.3, respectively. Scores improved to 94.1 ± 8.2, 46.6 ± 11.6 and 88.2 ± 14.6 at the last follow up, respectively. Mean preoperative WOMAC scores of 75.8 ± 16.5 improved to 13.8 ± 16.0 at last follow-up. Five knees required re-operation, two for liner breakage, one for liner wear, one for distal femoral fracture and one for infection. The estimated 10-year prosthesis survival rates for any reason and for prosthesis-related problems were 95.5% and 97.4% , respectively.TKAs using each techniques resulted in similar good clinical outcomes and postoperative leg alignments. Robotic and navigation TKA appeared to reduce the number of postoperative leg alignment outliers and revision rate compared to conventional TKA.

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Clinical Outcomes Following Revision Total Knee Arthroplasty: Minimum 2-Year Follow-up

Clinics in Orthopedic Surgery ◽

10.4055/cios20206 ◽

2021 ◽

Vol 13 ◽

Author(s):

Jonathan Quinn ◽

Peter Jones ◽

Ray Randle

Keyword(s):

Total Knee Arthroplasty ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Revision Total Knee Arthroplasty ◽

Total Knee

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The iAssist Navigation System Demonstrated Superior Radiological Outcomes in Restoring Mechanical Alignment and Component Sagittal Positioning in Total Knee Arthroplasty

10.21203/rs.3.rs-117247/v1 ◽

2020 ◽

Author(s):

Jiaxiang Gao ◽

Yunfei Hou ◽

Zhichang Li ◽

Runjun Li ◽

Yan Ke ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Navigation System ◽

Clinical Parameters ◽

Mechanical Alignment ◽

Absolute Deviation ◽

Total Knee ◽

The Absolute

Abstract Background: This study aimed to determine whether the iAssist navigation system (NAV) could improve the accuracy of restoring mechanical axis (MA), component positioning, and clinical outcomes compared to conventional (CON) total knee arthroplasty (TKA). Methods: A total of 301 consecutive patients (NAV: 27, CON: 274) were included. A 1:4 propensity score matching (PSM) was performed between the two groups according to preoperative demographic and clinical parameters. The postoperative MA, femoral coronal angle (FCA), femoral sagittal angle (FSA), tibial coronal angle (TCA) and tibial sagittal angle (TSA) were compared. Absolute deviations of aforementioned angles were calculated as the absolute value of difference between the exact and ideal value and defined as appropriate if within 3°, otherwise regarded as outliers. Additional clinical parameters, including the Knee Society knee and function scores (KSKS and KSFS) and range of motion (ROM), were assessed at the final follow-up (mean follow-up time was 21.88 and 21.56 months respectively for NAV and CON group). Results: A total of 98 patients/102 knees were analyzed after the PSM (NAV: 21 patients/24 knees, CON: 77 patients/78 knees). In the NAV group, the mean MA, FCA and TSA were significantly improved (p = 0.019, 0.006, <0.001, respectively). Proportions of TKAs within a ±3°deviation were significantly improved in all the postoperative radiological variables except for TCA (p = 0.003, 0.021, 0,017, 0.013, respectively for MA, FCA, FSA, and TSA). The absolute deviations of FSA and TSA were also significantly lower in the NAV group (p = 0.016, 0.048, respectively). In particular, no significant differences were found in either mean value, absolute deviation or outlier ratio of TCA between two groups. For the clinical outcomes, there were no significant differences between two groups, although KSKS, KSFS and ROM (p<0.01, respectively) dramatically improved compared to baseline. Conclusions: We suggested that the iAssist system could improve the accuracy and precision of mechanical alignment and component positioning without significant improvement of clinical outcomes. Further long-term high-quality studies are necessary to validate the results.

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Clinical Outcomes of a Modern Total Knee Arthroplasty Prosthesis Compared to Its Predecessor at 5-Year Follow-Up: Matched Pair Analysis

The Journal of Arthroplasty ◽

10.1016/j.arth.2020.06.024 ◽

2020 ◽

Vol 35 (11) ◽

pp. 3150-3155

Author(s):

Peter B. White ◽

Sava Turcan ◽

James R. Satalich ◽

Amar S. Ranawat ◽

Chitranjan S. Ranawat

Keyword(s):

Total Knee Arthroplasty ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Matched Pair ◽

Matched Pair Analysis ◽

Total Knee ◽

Pair Analysis

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Comparison of Clinical Outcomes Between Total Knee Arthroplasties Using Medial-Pivot and Posterior-Stabilized Prosthesis: Minimum 8-year Follow-up Results in Chinese population

10.21203/rs.3.rs-18309/v1 ◽

2020 ◽

Author(s):

Zheng-yu Gao ◽

Cui-cui Guo ◽

Zi-an Zhang ◽

Guang-qian Shang ◽

Wei-ning Yan ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Survival Rate ◽

Range Of Motion ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Womac Index ◽

Prosthesis Survival ◽

Medial Pivot ◽

Total Knee

Abstract Objective To compare the clinical outcomes of Medial-pivot and Posterior-stablized total knee arthroplasty during 8 years follow-up. Methods 109 patients with osteoarthritis who underwent primary total knee arthroplasty were conducted and divided into two groups according to the choice of prosthesis,49 in the Medial-pivot(MP) group and 60 in the Postirior-stabilized(PS) group.There were no statistical differences in age,gender,BMI,operative side and operation time between the two groups (P>0.05).The same protocol of perioperative treatment was adopted in both groups. Comparison of clinical outcome and survival rates were acquired through minimum 8 years follow-up. Results The prosthesis survival rate andthe excellent and good rate of MP group were 93.9% and 88.9% during average 8.3 years follow-up period,versus the prosthesis survival rate and the excellent or good rate of PS group were 93.3% and 86.7% during average 8.4 years follow-up period.There were no statistical diferences in survival rate,excellent and good rate and radiolucency of weight-bearing areas between the two groups ( P >0.05). There were no statistical differences in range of motion,KSS score and WOMAC index between the two groups preoperatively (P>0.05).The range of motion at all follow-up time points and KSS score at 6 months postoperatively of PS group were superior than those of MP group ( P <0.05),while the WOMAC index at 8 years postoperatively and Kujala scores at 1year and 8 years postoperatively of PS group were better than those of MP group( P <0.05). Conclusion Either medial-pivot or post-stabilized total knee arthroplasty could obtain excellent or good mid-term clinical result. Although with less range of motion, the patients using MP prosthesis could obtain better results in bone loss, performance of the patellofemoral joint and mid-term satisfaction. However, the use of MP prosthesis required more professional and precise technology and it should be cautious when using for knees with severe valgus deformation.

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