Comparison of a vitamin E-infused highly crosslinked polyethylene insert and a conventional polyethylene insert for primary total knee arthroplasty at two years postoperatively

2019 ◽  
Vol 101-B (5) ◽  
pp. 559-564 ◽  
Author(s):  
S. Takemura ◽  
Y. Minoda ◽  
R. Sugama ◽  
Y. Ohta ◽  
S. Nakamura ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Vitamin E ◽  
Knee Arthroplasty ◽  
Study Group ◽  
Polyethylene Insert ◽  
Knee Prostheses ◽  
Radiological Results ◽  
Significant Difference ◽  
Total Knee ◽  
Clinical And Radiological Results

AimsThe use of vitamin E-infused highly crosslinked polyethylene (HXLPE) in total knee prostheses is controversial. In this paper we have compared the clinical and radiological results between conventional polyethylene and vitamin E-infused HXLPE inserts in total knee arthroplasty (TKA).Patients and MethodsThe study included 200 knees (175 patients) that underwent TKA using the same total knee prostheses. In all, 100 knees (77 patients) had a vitamin E-infused HXLPE insert (study group) and 100 knees (98 patients) had a conventional polyethylene insert (control group). There were no significant differences in age, sex, diagnosis, preoperative knee range of movement (ROM), and preoperative Knee Society Score (KSS) between the two groups. Clinical and radiological results were evaluated at two years postoperatively.ResultsDifferences in postoperative ROM and KSS were not statistically significant between the study and control groups. No knee exhibited osteolysis, aseptic loosening, or polyethylene failure. Additionally, there was no significant difference in the incidence of a radiolucent line between the two groups. One patient from the study group required irrigation and debridement, due to deep infection, at six months postoperatively.ConclusionClinical results were comparable between vitamin E-infused HXLPE inserts and conventional polyethylene inserts at two years after TKA, without any significant clinical failure. Cite this article: Bone Joint J 2019;101-B:559–564.

COMPARISON OF HIGH FLEXION DESIGN AND POSTERIOR STABILIZATION PROSTHESES OF TOTAL KNEE ARTHROPLASTY BY GAIT ANALYSIS

2009 ◽  
Vol 21 (01) ◽  
pp. 71-79
Author(s):  
Wen-Chi Tsai ◽  
Sheng-Chang Chen ◽  
Tung-Wu Lu ◽  
Hwa-Chang Liu
Keyword(s):  
Total Knee Arthroplasty ◽  
Gait Analysis ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Objective Assessment ◽  
Knee Prostheses ◽  
High Flexion ◽  
Significant Difference ◽  
Post Operation ◽  
Total Knee

Introduction: The primary goal of total knee arthroplasty (TKA) is to resolve knee destruction and associated problems at the end stages of diseases such as osteoarthritis and rheumatoid arthritis. High satisfactory rate has been reported in terms of pain relief and correction of deformity. However, the method for objective assessment of the outcome, such as range of motion (ROM) and quantitative evaluation of the clinical outcome of TKA, is to be confirmed. The purpose of this study was mandatory to investigate the ROM objectively and the newly designed prostheses. Materials and methods: The study was done in randomly selected patients who received dynamic measurement of knee function. Twenty-six patients participated in the study. They were divided into two groups (13 patients in A and 13 patients in B group), according to the knee prostheses they had received. Basic knee functions were evaluated in various dynamic activities, including nonweight bearing status of knee flexion, level walking, kneeling, and squatting, using computerized gait analysis techniques (Vicon 512 system). Passive knee ROM and static alignment were measured using traditional goniometer. HSS scores, physical, and neural examination were recorded. Results: After comparing patients in almost similar criteria, results have shown that there was no significant difference between two types of knee prostheses in randomly selective patients. Conclusion: Newly designed prostheses for achieving higher flexion angle cannot guarantee to provide better knee flexion for every patient. A patient, who can achieve higher knee flexion in pre-operative status, will have high flexion results in post-operative result. In other words, poor knee flexion function in pre-operation will lead to poor knee flexion function in post-operation status. Minor prosthesis design has little to do with the surgical outcome of knee flexion.

Isolated revision of the polyethylene component at revision total knee arthroplasty has excellent survivorship at ten years

2019 ◽  
Vol 101-B (7_Supple_C) ◽  
pp. 104-107 ◽  
Author(s):  
P. H. Greenwell ◽  
W. P. Shield ◽  
D. M. Chapman ◽  
D. F. Dalury
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Soft Tissues ◽  
Revision Total Knee Arthroplasty ◽  
Study Group ◽  
Polyethylene Insert ◽  
Total Knee ◽  
The Mean ◽  
Mean Time

AimsThe aim of this study was to establish the results of isolated exchange of the tibial polyethylene insert in revision total knee arthroplasty (RTKA) in patients with well-fixed femoral or tibial components. We report on a series of RTKAs where only the polyethylene was replaced, and the patients were followed for a mean of 13.2 years (10.0 to 19.1).Patients and MethodsOur study group consisted of 64 non-infected, grossly stable TKA patients revised over an eight-year period (1998 to 2006). The mean age of the patients at time of revision was 72.2 years (48 to 88). There were 36 females (56%) and 28 males (44%) in the cohort. All patients had received the same cemented, cruciate-retaining patella resurfaced primary TKA. All subsequently underwent an isolated polyethylene insert exchange. The mean time from the primary TKA to RTKA was 9.1 years (2.2 to 16.1).ResultsAt final follow-up, 13 patients had died, leaving 51 patients for study. Only seven of these patients had required re-operation. Knee Society scores (KSS) prior to RTKA were a mean of 78.4 (24 to 100). By six weeks post-revision, the mean total KSS was 93.5 (38 to 100) and at final follow-up, they had a mean of 91.6 (36 to 100).ConclusionIn appropriate circumstances, where the femoral and tibial components are satisfactorily aligned and well fixed, and where the soft tissues can be balanced, a polyethylene exchange alone can provide a durable solution for these RTKA patients. Cite this article: Bone Joint J 2019;101-B(7 Supple C):104–107

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