Range of Motion after High-Flexion Posterior Stabilized Total Knee Arthroplasty - Minimum 3-year Follow Up -

Intro- For TKA, there are two types of bearing designs: xed-bearing and mobile-bearing. Round femoral components articulate with a relatively at tibial articular surface in a xed-bearing knee design. Because the insert does not hinder the natural movements of the femoral component, the mobile-bearing (MB) TKA design is thought to allow more exibility of motion than the xed-bearing (FB) variety. Aim and objective: To compare xed bearing and mobile bearing total knee arthroplasty. Material and methods:This study is a prospective type of study done at Seth GS medical college Mumbai, Department of Orthopaedics during August 2019 to June 2021 on patients undergoing total knee arthroplasty. Patients who were to undergo total knee arthroplasty were invited to take part in the study. This study, done on them was explained in detail to them. An informed consent was obtained. Patients fullling the inclusion criteria were listed. Result: Range of motion achieved after mobile arthroplasty was 123.62±2.94 and in xed arthroplasty it was 121.96±2.74. Pain after last follow up in mobile arthroplasty was 48.83±0.62 and for xed arthroplasty was 47.39±0.86. Flexion gap after last follow up in mobile arthroplasty was 24.13±0.45 and in xed was 24.02±0.45. Stability was almost similar in both mobile and xed arthroplasty. Conclusions: there is no signicant difference between xed arthroplasty and mobile arthroplasty as far as Range of motion, Pain ,Flexion gap. Stability was almost similar in both mobile and xed arthroplasty.

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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

The Journal of Knee Surgery ◽

10.1055/s-0039-1693023 ◽

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.

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Prospective randomized trial of standard versus highly crosslinked tibial polyethylene in primary posterior-stabilized total knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.101b7.bjj-2018-1126.r2 ◽

2019 ◽

Vol 101-B (7_Supple_C) ◽

pp. 33-39 ◽

Cited By ~ 3

Author(s):

P. F. Lachiewicz ◽

J. A. O’Dell

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Randomized Study ◽

Posterior Stabilized ◽

Function Score ◽

Score Change ◽

Osteolytic Lesions ◽

Significant Difference ◽

Total Knee

Aims There is insufficient evidence to recommend the use of alternative polyethylene bearings in modular, fixed-bearing total knee arthroplasty (TKA). The purpose of this study was to compare standard polyethylene (SP) and highly crosslinked polyethylene (XLP) tibial liners in posterior-stabilized TKA, with osteolysis as the primary outcome and clinical results and the rate of re-operation as the secondary outcomes. Patients and Methods This is a single-surgeon, prospective randomized study involving one design of modular posterior-stabilized TKA. An analysis of 122 TKAs with an SP compression moulded liner and 123 with an XLP liner was performed, with a mean follow-up of six years (2 to 11). Patients were evaluated clinically using the Knee Society score, Lower Extremity Activity Score (LEAS), and the presence of an effusion, and standard radiographs were assessed for radiolucent lines and osteolytic lesions. Results Osteolysis was present in four TKAs (3.3%) in the SP group, and no knees in the XLP group (p = 0.06). There were no significant differences between the Knee Society total score, change in total score, knee function score, change in function score, LEAS, and change in LEAS in the two groups. There was a significant difference in the presence of an effusion (10/122 with SP liners, 1/123 with XLP liners; p = 0.02). There was no significant difference in the rate of re-operation between the two groups (p = 0.36). There were no complications related to the XLP liner. Conclusion At this length of follow-up, there were no advantages and no complications related to the use of this XLP tibial liner. The presence of effusion and small osteolytic lesions was more frequent with SP than XLP liners, but of unknown clinical significance. Cite this article: Bone Joint J 2019;101-B(7 Supple C):33–39

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Range of Motion in Total Knee Arthroplasty: A Prospective Comparison of High-Flexion and Standard Cruciate-Retaining Designs

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.h.00300 ◽

2009 ◽

Vol 91 (3) ◽

pp. 672-679 ◽

Cited By ~ 41

Author(s):

Jong Keun Seon ◽

Sang Jin Park ◽

Keun Bae Lee ◽

Taek Rim Yoon ◽

Michal Kozanek ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Range Of Motion ◽

Knee Arthroplasty ◽

Cruciate Retaining ◽

High Flexion ◽

Prospective Comparison ◽

Total Knee

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

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0086 ◽

2017 ◽

Vol 99 (8) ◽

pp. 602-606 ◽

Cited By ~ 4

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.

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