Long-term outcome of low contact stress total knee arthroplasty with different mobile bearing designs

Purpose: to evaluate the differences in clinical outcome and survivorship of three different mobile bearings for total knee arthroplasty. Methods: a retrospective study was conducted in 60 patients (53 females, 7 males, mean age: 68 years and 5 months) each submitted to total knee replacement using one of the three different mobile bearings of the LCS system (Depuy Johnson & Johnson, Warsaw, IN). The diagnosis was knee osteoarthritis in 57 cases and rheumatoid arthritis in three cases. Three different groups of 20 cases each were identified: total knee arthroplasties with mobile menisci (group 1); total knee arthroplasties with the rotating platform (group 2); and total knee arthroplasties with the anteroposterior glide platform (group 3). As regards the component fixation, 33 implants were cementless, three were cemented, and in 24 only the tibial component was cemented. The patella was not replaced. Results: although the duration of follow-up differed between the three groups, the clinical and radiological results at final follow-up showed no revision of femoral and/or tibial components for mechanical or septic reasons, and no signs of impending failure. One meniscal bearing, showing polyethylene wear after 17 years, was successfully replaced. Conclusions: the present retrospective study confirmed the long-term effectiveness of knee implants with mobile bearings, in which the congruity of the surfaces makes it possible to overcome the problem of high contact stresses that may result in polyethylene wear and osteolysis; at the same time, these implants eliminate constraint forces thereby reducing the risk of mechanical loosening. Level of evidence: Level III, retrospective comparative study.

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Long-term outcome following total knee arthroplasty: a controlled longitudinal study

Annals of the Rheumatic Diseases ◽

10.1136/ard.2008.093229 ◽

2008 ◽

Vol 68 (5) ◽

pp. 642-647 ◽

Cited By ~ 66

Author(s):

J Cushnaghan ◽

J Bennett ◽

I Reading ◽

P Croft ◽

P Byng ◽

...

Keyword(s):

Body Mass Index ◽

Total Knee Arthroplasty ◽

Physical Function ◽

Knee Arthroplasty ◽

Term Outcome ◽

Long Term Outcome ◽

Sf 36 ◽

Total Knee

Objectives:To assess long-term outcome and predictors of prognosis following total knee arthroplasty (TKA) for osteoarthritis.Methods:We followed-up 325 patients from 3 English health districts approximately 6 years after TKA, along with 363 controls selected from the general population. Baseline data, collected by interview and examination, included age, sex, comorbidity, body mass index (BMI), functional status and preoperative radiographic severity of osteoarthritis. Functional status at follow-up was assessed by postal questionnaire. Predictors of change in physical function were analysed by linear regression.Results:Between baseline and follow-up, patients reported an improvement of 6 points in median Short Form 36 Health Survey (SF-36) physical function score, whereas in controls there was a deterioration of 14 points (p<0.001). Median SF-36 vitality score declined by 10 points in patients and 5 points in controls (p = 0.005), while their median SF-36 mental health scores improved by 12 and 13 points, respectively (p = 0.2). The improvement in physical function was smaller in patients who were obese than in patients who were non-obese, but compared favourably with a substantial decline in the physical function of obese controls. Better baseline physical function and older age predicted worse changes in physical function in patients and controls. Improvement in physical function tended to be greater in patients with more severe radiological disease of the knee, and was less in those who reported pain at other joint sites at baseline.Conclusions:Improvements in physical function following TKA for osteoarthritis are sustained beyond 5 years. The benefits are apparent in patients who are obese as well as non-obese, and there seems no justification for withholding TKA from obese patients solely on the grounds of their body mass index.

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Total Knee Arthroplasty Is Safe in Jehovah's Witness Patients—A 12-Year Perspective

The Journal of Knee Surgery ◽

10.1055/s-0038-1676372 ◽

2019 ◽

Vol 33 (01) ◽

pp. 034-041 ◽

Cited By ~ 1

Author(s):

Theodore S. Wolfson ◽

David Novikov ◽

Kevin K. Chen ◽

Kelvin Y. Kim ◽

Afshin A. Anoushiravani ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Postoperative Complications ◽

Knee Arthroplasty ◽

Subgroup Analysis ◽

Blood Management ◽

Folate Supplementation ◽

Level Of Evidence ◽

Significant Difference ◽

Total Knee

AbstractDespite the evolution of blood management protocols, total knee arthroplasty (TKA) occasionally requires allogeneic blood transfusion. This poses a particular challenge for Jehovah's Witnesses (JW) who believe that the Bible strictly prohibits the use of blood products. The aim of this study was to compare JW and a matched-control cohort of non-JW candidates undergoing TKA to assess the safety using modern blood management protocols. Fifty-five JW patients (63 knees) who underwent TKA at our institution between 2005 and 2017 were matched to 63 non-JW patients (63 knees). Patient demographics, intraoperative details, and postoperative complications including in-hospital complications, revisions, and 90-day readmissions were collected and compared between the groups. Additionally, subgroup analysis was performed comparing JW patients who were administered tranexamic acid (TXA) between the two groups. Baseline demographics did not vary significantly between the study cohorts. The mean follow-up was 3.1 years in both the JW and non-JW cohorts. Postoperative complications, including in-hospital complications (7.9 vs. 4.8%; p = 0.47), revision TKA (1.6 vs. 1.6%; p = 1.00), and 90-day readmission (1.6 vs. 4.8%; p = 0.31) were not significantly different between the JW and non-JW groups. Subgroup analysis demonstrated JW patients who received TXA had a significantly lower decline in postoperative hemoglobin (Hgb) (8.6 vs. 14.0%; p < 0.01). At a follow-up of up to 12 years, JW patients who underwent TKA have outcomes equivalent to non-JW patients without the need for transfusion. Our findings support that surgeons are more likely to optimize JW patients preoperatively with iron and folate supplementation. Despite these variations in preoperative optimization efforts, no significant difference with regard to Hgb or hematocrit levels was demonstrated. Level of evidence is III, retrospective observational study.

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Robotic versus conventional primary total knee arthroplasty: clinical and radiological long-term results with a minimum follow-up of ten years

International Orthopaedics ◽

10.1007/s00264-018-4231-1 ◽

2018 ◽

Vol 43 (6) ◽

pp. 1345-1354 ◽

Cited By ~ 14

Author(s):

Kyu-Jin Cho ◽

Jong-Keun Seon ◽

Won-Young Jang ◽

Chun-Gon Park ◽

Eun-Kyoo Song

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Primary Total Knee Arthroplasty ◽

Long Term Results ◽

Total Knee ◽

Primary Total Knee

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Long Term Outcome of Total Knee Arthroplasty. The Effect of Navigation

Total Knee Arthroplasty ◽

10.1007/978-1-4471-6660-3_25 ◽

2015 ◽

pp. 245-254

Author(s):

Aristides Zimbis ◽

Theofilos Karachalios

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Term Outcome ◽

Long Term Outcome ◽

Total Knee

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Titanium-Nitride Coating Does Not Result in a Better Clinical Outcome Compared to Conventional Cobalt-Chromium Total Knee Arthroplasty after a Long-Term Follow-Up: A Propensity Score Matching Analysis

Coatings ◽

10.3390/coatings10050442 ◽

2020 ◽

Vol 10 (5) ◽

pp. 442 ◽

Cited By ~ 1

Author(s):

Georg Hauer ◽

Lukas Leitner ◽

Marc C. Ackerl ◽

Sebastian Klim ◽

Ines Vielgut ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Propensity Score ◽

Knee Arthroplasty ◽

Cobalt Chromium ◽

Tin Coating ◽

Long Term Follow Up ◽

Total Knee ◽

Cocr Alloy

Background: The impact of titanium nitride (TiN) coating on implant components is controversial. TiN coating is proposed as having superior biomechanical properties compared to conventional cobalt-chromium (CoCr) alloy. This study compared long-term clinical data as well as meteoro-sensitivity in patients who underwent total knee arthroplasty (TKA), with either CoCr alloy or TiN coating. Methods: In this retrospective observational study, the clinically approved cemented “low contact stress” (LCS) TKA with conventional CoCr coating, was compared to un-cemented TiN-coated “advanced coated system” (ACS) TKA. Propensity score matching identified comparable patients based on their characteristics in a one-to-one ratio using the nearest-neighbor method. The final cohort comprised 260 knees in each cohort, with a mean follow-up of 10.1 ± 1.0 years for ACS patients and 14.9 ± 3.0 years for the LCS group. Physical examinations, meteoro-sensitivity, and knee scoring were assessed. Results: The clinical and functional Knee Society Score (KSS) (82.6 vs. 70.8; p < 0.001 and 61.9 vs. 71.1; p = 0.011), the postoperative Visual Analogue Scale (VAS) (2.9 vs. 1.4; p = 0.002), and the postoperative Tegner Score (2.6 vs. 2.2; p = 0.001) showed significant intergroup differences. The postoperative Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) was similar (79.9 vs. 81.3; p = 0.453) between groups. Meteoro-sensitivity of the artificial joint was significantly more prevalent in the ACS patient cohort (56% vs. 23%; p < 0.001). Conclusion: This study suggests that TiN coating does not provide improved clinical outcomes in this patient cohort after a long-term follow-up. Interestingly, sensitivity to weather changes were more correlated with un-cemented ACS implants.

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Long-Term Postoperative Total Knee Arthroplasty Flexion Scores in Relation to Body Mass Index

The Journal of Knee Surgery ◽

10.1055/s-0040-1718601 ◽

2020 ◽

Author(s):

Matthew A. Siegel ◽

Michael J. Patetta ◽

Angie M. Fuentes ◽

Armaan S. Haleem ◽

Craig W. Forsthoefel ◽

...

Keyword(s):

Body Mass Index ◽

Total Knee Arthroplasty ◽

Body Mass ◽

Knee Arthroplasty ◽

Statistical Significance ◽

P Value ◽

Preoperative Body Mass Index ◽

Total Knee

AbstractKnee range of motion (ROM) is an important postoperative measure of total knee arthroplasty (TKA). There is conflicting literature whether patients who are obese have worse absolute ROM outcomes than patients who are not obese. This study analyzed whether preoperative body mass index (BMI) influences knee ROM after patients' primary TKA. A retrospective investigation was performed on patients, who underwent primary TKA at an academic institution, by one of three fellowship-trained adult reconstruction surgeons. Patients were stratified according to their preoperative BMI into nonobese (BMI < 30.0 kg/m2) and obese (BMI ≥ 30.0 kg/m2) classifications. Passive ROM was assessed preoperatively as well as postoperatively at patients' most recent follow-up visit that was greater than 2 years. Mann–Whitney U tests were performed to determine statistical significance at p-value <0.05 for ROM outcomes. No statistically significant differences were observed when ROM in the nonobese group was compared with ROM in the obese group both preoperatively (105.73 ± 11.58 vs. 104.14 ± 13.58 degrees, p-value = 0.417) and postoperatively (105.83 ± 14.19 vs. 104.49 ± 13.52 degrees, p-value = 0.777). Mean follow-up time for all patients was 4.49 ± 1.92 years. In conclusion, long-term postoperative ROM outcomes were similar between patients who were nonobese and patients who were obese.

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