scholarly journals Midterm Results of Cementless Total Knee Arthroplasty: A Retrospective Case Series

2018 ◽  
Vol 12 (1) ◽  
pp. 196-202 ◽  
Author(s):  
Radosław Stempin ◽  
Kacper Stempin ◽  
Wiesław Kaczmarek ◽  
Julian Dutka
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Case Series ◽  
Hardness Test ◽  
Midterm Results ◽  
Cruciate Retaining ◽  
Total Knee ◽  
Selection Of

Background: There is an ongoing debate about whether to use cementless or cemented fixation for Total Knee Arthroplasty (TKA). Objective: The study aimed to assess midterm survivorship of the Vanguard cementless system, and to demonstrate the utility of the Bone Hardness Test (BHT) for the selection of cementless fixation TKA. Methods: From September 2009 through November 2014, 123 total knee arthroplasties were completed, with cementless Vanguard Cruciate Retaining TKA in 110 knees (102 patients) and cemented Vanguard in 13 cases (12 patients). Implant fixation was based on intraoperative assessment of posterior cruciate ligament stability, bone quality, and BHT. All patients with a cementless Vanguard implant were eligible for this retrospective study. Preoperative and postoperative Knee Society Score and Western Ontario and McMaster Universities Osteoarthritis Index were obtained. Standardized standing anteroposterior and lateral radiographs were taken. Results: Three patients (4 TKAs) were lost to follow-up. The mean follow-up time was 5.5 ± 1.4 years. All scores significantly improved postoperatively. No radiographic failures were observed. Five-year implant survival, with revision of any component for any reason as an endpoint, was 97.2% (95% confidence interval, 91.7 - 99.1%). Five-year survival with revision for aseptic loosening was 100%. Only one knee required revision due to an isolated unrelated bearing exchange, and two additional knees required secondary resurfacing of the patella for retropatellar pain. Conclusion: Good midterm results were obtained with the cementless Vanguard Cruciate Retaining TKA for the treatment of osteoarthritis. The Bone Hardness Test appears to be an effective way to determine the selection of cementless TKA.

scholarly journals Cruciate retaining versus posterior-stabilized total knee arthroplasty: a short-term comparative study

2018 ◽  
Vol 4 (5) ◽  
pp. 726
Author(s):  
Raghav K. Suthar ◽  
Dimple R. Parekh ◽  
Shaival B. Mistry
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Posterior Stabilized ◽  
Superficial Infection ◽  
Cruciate Retaining ◽  
Knee Deformity ◽  
Subjective Score ◽  
Total Knee

<p class="abstract"><strong>Background:</strong> Total knee arthroplasty has got excellent results. Among the techniques (posterior-stabilized vs posterior cruciate retaining total knee arthroplasty) it is unclear whether one design has superior outcome over another. The purpose of the present study was to directly compare clinical and radiological outcomes of these two designs.</p><p class="abstract"><strong>Methods:</strong> A prospective study involving 36 patients who received a cruciate-retaining implant were compared to 30 patients who received posterior-stabilized prosthesis. At 3 months follow-up time clinical and radiological evaluation done and results were analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> At 3 months follow-up time mean knee society scores improved from 49.9/46.9 (objective/subjective score) points to 80.9/82.5 points in the cruciate-retaining group and from 48.2/43 (objective/subjective score) points to 80.4/80.2 points in the posterior-stabilized group. The ranges of motion was 117.2° (range, 90° to 130°) and 125.3° (range, 100° to 140°) in the cruciate-retaining and posterior-stabilized group respectively, at 3 month follow-up. One patient had post-operatively periprosthetic fracture reported after 2 weeks (treated conservatively), one had superficial infection (treated with dressing) and one patient with superfical infection required debridement.</p><p class="abstract"><strong>Conclusions:</strong> This study did not conclusively demonstrate the superiority of one knee design over the other, suggesting that the choice of implant should be based on surgeon preference, patients knee dimensions, pre-op knee deformity and existing pathology of the posterior cruciate ligament.</p>

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 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.

scholarly journals Cruciate Retaining compared with Posterior Stabilised Nexgen total knee arthroplasty: results at 10 years in a matched cohort

2017 ◽  
Vol 99 (8) ◽  
pp. 602-606 ◽  
Author(s):  
AIW Mayne ◽  
HP Harshavardhan ◽  
LR Johnston ◽  
W Wang ◽  
A Jariwala
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Functional Score ◽  
Range Of Movement ◽  
Cruciate Retaining ◽  
Score Improvement ◽  
Total Knee

INTRODUCTION Debate has persisted for many years about whether to sacrifice or replace the posterior cruciate ligament when performing total knee arthroplasty. A paucity of long-term follow-up studies comparing outcomes between cruciate-retaining and posterior-stabilised knees exist. We aimed to compare results at ten-year follow-up. METHODS A matched paired study comparing a cohort of 107 Zimmer Nexgen® Cruciate Retaining (CR) patients with a cohort of 107 Nexgen Posterior-Stabilised (PS) knees matched for age, sex, body mass index and preoperative American Knee Society score was undertaken. All patients underwent independent clinical assessment and knee society scoring preoperatively and at 1, 3, 5, 7 and 10 years postoperatively. RESULTS Fifty-three patients (49.5%) in the CR group and 44 patients (41.1%) in the PS group were alive at 10-year follow-up. There were no significant differences between the CR and PS groups with regards to functional assessment (P = 0.95), overall range of movement (P = 0.46) or patient satisfaction (P = 1.0) at 10 years. However, there was a significantly better score improvement in range of movement in PS knees compared with CR knees (P = 0.027). There were six revisions (5.6%) in the PS group and 1 (0.93%) in the CR group (P = 0.12). Both CR and PS knees showed excellent survivorship with no significant difference at 10 years (P = 0.068). CONCLUSIONS There were no significant differences in functional score, overall range of motion or patient satisfaction between the Nexgen cruciate retaining and posterior stabilised total knee arthroplasty at 10-year follow-up. However, PS knees had a greater score improvement in range of motion compared with CR knees.

scholarly journals Obliteration of Intercondylar Notch Mimicking Flexion-Extension Gap Imbalance in a Cruciate Retaining Total Knee Arthroplasty

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Harun Resit Gungor ◽  
Esat Kiter ◽  
Semih Akkaya ◽  
Nusret Ok ◽  
Cagdas Yorukoglu
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Soft Tissues ◽  
Cruciate Ligament ◽  
Early Postoperative Period ◽  
Intercondylar Notch ◽  
Cruciate Retaining ◽  
Flexion Extension ◽  
Total Knee

Following total knee arthroplasty (TKA), the most frequent cause of extension deficit and limitation of range of motion in early postoperative period is related to improper tensioning of soft tissues and failure to balance extension and flexion gaps. If a cruciate retaining (CR) prosthesis is the planned implant, then attention should be given to balancing the posterior cruciate ligament (PCL), and any factor that alters this balance may also cause deterioration of knee balance in postoperative period. Here, we report on an unusual case referred from another hospital because of continuous pain and restriction of knee motion in early postoperative period following CR-designed TKA that was initially thought to be due to flexion-extension imbalance. However, during the revision procedure, extruded cement to the intercondylar notch was found to be both mechanically blocking terminal extension and limiting flexion by possible mechanism of irritation of the synovial nerve endings around the stretched anterior fibers of PCL during flexion. This case was successfully treated by removal of extruded cement from intercondylar notch to decompress PCL, polyethylene exchange, and secondary patellar resurfacing.

scholarly journals Midterm results of cruciate retaining total knee arthroplasty in patellectomized patients

2013 ◽  
Vol 47 (1) ◽  
pp. 31 ◽  
Author(s):  
Vivek Dahiya ◽  
Himanshu Gupta ◽  
Ashok Rajgopal ◽  
Attique Vasdev
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Midterm Results ◽  
Cruciate Retaining ◽  
Total Knee

scholarly journals Cement Arthrodesis of the Knee with a Custom Long Recon Nail After Failed Total Knee Arthroplasty: Surgical Technique and Results

2018 ◽  
Vol 12 (1) ◽  
pp. 554-566
Author(s):  
Malcolm R. DeBaun ◽  
Stuart B. Goodman ◽  
David W. Lowenberg
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Joint Infection ◽  
Treatment Algorithm ◽  
Case Series ◽  
Cement Spacer ◽  
Knee Arthrodesis ◽  
Retrospective Case ◽  
Total Knee

Background and Objective: Persistent periprosthetic joint infection (PJI) is a devastating complication after Total Knee Arthroplasty (TKA). We hypothesize that our novel treatment algorithm utilizing a customized knee spanning recon nail combined with an antibiotic eluting cement spacer improves ambulation status and prevents recurrent PJI in patients with failed TKA and severe bone loss. Methods: In a retrospective case series, 15 consecutive patients who underwent knee arthrodesis after failed ipsilateral TKA secondary to infection from 2004-2017 with at least 1 year of follow-up were enrolled. The average age of patients at the time surgery was 68 (range 50-81) years with an average follow-up of 3.2 (range 1-6) years. Post-surgical ambulation status and eradication of index infection were analyzed as primary outcomes using McNemar’s test for before-and-after study design with p<0.05 for significance. Results: Cement arthrodesis significantly improved ambulation with 67% (10/15) of patients unable to ambulate before arthrodesis and 93% (14/15) of patients able to ambulate at final follow-up (p=0.004). The complication rate was 20% (3/15). There were no periprosthetic fractures. Amongst patients who presented with active PJI, 91% (10/11) had eradication of their index infection final follow-up (p=0.002). Overall prevention of recurrent index infection was 93% (14/15) (p=0.0001). Conclusion: Cement arthrodesis utilizing a custom knee spanning recon nail combined with an antibiotic eluting spacer improves ambulation status and prevents or treats recurrent infection in the majority of patients who have failed total knee arthroplasty.

scholarly journals Pigmented villonodular synovitis does not influence the outcomes following cruciate-retaining total knee arthroplasty: a case-control study with minimum five year follow-up

2020 ◽  
Author(s):  
Wei Lin ◽  
Yike Dai ◽  
Jinghui Niu ◽  
Guangmin Yang ◽  
Ming Li ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Society Score ◽  
Pigmented Villonodular Synovitis ◽  
Control Group ◽  
Villonodular Synovitis ◽  
Cruciate Retaining ◽  
Total Knee ◽  
Pigmented Villonodular

Abstract Background: Pigmented villonodular synovitis (PVNS) is a rare synovial disease with benign hyperplasia, which has been successfully treated with total knee arthroplasty (TKA). The purpose of this study was to investigate the middle-term follow-up outcomes of cruciate-retaining (CR) TKA in patients with PVNS.Methods: From January 2012 to December 2014, a retrospective study was conducted in 17 patients with PVNS who underwent CR TKA as PVNS group. During this period, we also selected 68 patients with osteoarthritis who underwent CR TKA (control group) for comparison. The two groups matched in a 1:4 ratio based on age, sex, body mass index and follow-up time. The range of motion, Knee Society Score, revision rate, disease recurrence, wound complications and the survivorship curve of Kaplan-Meier implant were assessed between the two groups.Results: All patients were followed up at least five years. There were no difference in range of motion, and Knee Society Score between the two groups before surgery and at last follow-up after surgery (p > 0.05). In the PVNS group, no patients with the recurrence of PVNS were found at the last follow-up, one patient underwent revision surgery due to periprosthetic fracture, and three patients had stiffness one year after surgery (17.6% vs 1.5%, p = 0.005; ROM:16°- 81°), but no revision was needed. At seven years, the implant survivorship was 90.0% in the PVNS group and 96.6% in the control group (p = 0.54).Conclusions: This study demonstrated that the function of patients with PVNS who underwent CR TKA had been significantly improved, and the survival rate of implants in these patients were similar to the patients with OA. Consequently, the patients with PVNS who underwent CR TKA might be an achievable option. However, these patients should pay more attention to the occurrence of postoperative stiffness complication.

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