Clinical Utility of Cruciate Retaining Total Knee Arthroplasty with Fourpegged Tibial Baseplate in the Valgus Knee: A Concise Minimum 4 Year Follow-up

2012 ◽  
Vol s2 (01) ◽  
Author(s):  
Shaun E Chandran
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Clinical Utility ◽  
Valgus Knee ◽  
Cruciate Retaining ◽  
Total Knee

scholarly journals Cruciate retaining versus posterior stabilized total knee arthroplasty for the treatment of valgus osteoarthritis?

2019 ◽  
Vol 7 (6_suppl4) ◽  
pp. 2325967119S0023
Author(s):  
Max Ettinger ◽  
Peter Savov ◽  
Henning Windhagen ◽  
Evelyn Mielke ◽  
Tilman Calliess
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Valgus Knee ◽  
Posterior Stabilized ◽  
Cruciate Retaining ◽  
Early Revision ◽  
Koos Score ◽  
Total Knee

Aims and Objectives: The debate of cruciate retaining (CR) versus posterior stabilized (PS) designs in total knee arthroplasty (TKA) is ongoing. With the posterior cruciate ligament retained, the TKA is supposed to function better in terms of proprioception, balance and kinematics. In contrast to that, PS designs are supposed to lead to higher degrees of flexion and a better femoral rollback. It is known, that the preoperative deformity negatively correlates with inferior results following TKA. When balancing a valgus knee, Ranawat et al. suggest to address the PCL in the first place. It is known that in 60% of valgus knees 1-2 soft tissue releases are necessary in order to achieve neutral alignment. Up to date no study exists, reporting the outcome of CR versus PS TKA in valgus knees. Thus, it was purpose of this study to evaluate the mid term outcome of CR versus PS TKA for the treatment of valgus OA in groups between 3°-6° of valgus, 7-10° of valgus and >10° of valgus. Materials and Methods: With the KOOS score as the primary endpoint, a sample size of 117 cases (78 CR and 39 PS) was needed in order to get a statistical power of 80%.Between 01-2011 and 03-2014 a total of 248 patients with a preoperative valgus >3° were treated with a CR TKA (167 cases) or a PS TKA (81 cases) of the same manufacturer (Stryker Triathlon, Stryker, Kalamazoo USA). CR patients were divided into the following groups: Preoperative valgus >3°-6°, 7°-10° and >10°. PS patients were divided into the following groups: Preoperative valgus >3°-6°, 7°-10° and >10°. The KOOS Score and the Oxford Knee score was collected at the time of follow up. For the CR and PS group failure rates and failure etiologies were analyzed. Patients demographics and were collected as well. Results: 141 patients were included into this study (97 CR and 44 PS cases). The CR group had a mean follow up of 57 weeks, the PS group had a follow up of 52weeks. In the CR group, 11/97 (11%) patients were revised due to a.p. instability, whereas 2/44 (5%) patients were revised in the PS group due to infection or aseptic loosening. There was no difference regarding OKS and the KOOS score between the two groups. Further, there was no difference regarding patients demographics and no correlation between the BMI and the clinical outcome. Conclusion: The most important findings of this study are that the CR group showed a significant higher early revision rate, whereas the clinical mid term follow up results are equal. The CR version of the used system showed significantly higher early failure due to a.p. instability.

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 The application of Patient specific Instrument （PSI ）in total knee arthroplasty with valgus knee

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0054
Author(s):  
Wang Yuehui ◽  
Zou Shiping ◽  
Cao Liangliang ◽  
Chen Wenzhong
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patient Specific ◽  
Valgus Knee ◽  
Specific Instrument ◽  
Guide Plate ◽  
Before And After ◽  
Total Knee ◽  
Surgery Department

Introduction: To invest the auxiliary role of Patient specific Instrument(PSI) used as osteotomy guide plate in total knee arthroplasty(TKA) with valgus knee. Hypotheses: PSI osteotomy guide plate is applicable for total knee arthroplasty with valgus knee. Methods: A retrospective analysis was performed on 21 patients with valgus knee, including 5 males and 16 females, who underwent TKA in joint surgery department I of ZhengZhou Orthopaedic Hospital from March 2016 to February 2018. All the operations were performed with the assistance of PSI, and the radiographic and clinical evaluations including femoral tibial joint ectropion angle(FTA) before and after operation, range of motion(ROM) and the Hospital for Special Surgery (HSS) knee score were reviewed, and surgical complications were recorded. Results: All the 21 patients werefollowed up for 10 ˜ 26 months (mean 16 months).All the incisions healed by first intention. The FTA was reduced significantly to 6.3 °±1.2° after operation from 17.6 ° + 5.7 °(P < 0.05), the ROM was improved significantly from preoperative 71.3° ±5.8° to postoperative 102.4°±7.5° (P < 0.05), the HSS score at the last follow-up was improved from 38.2±5.7 to 87.5-3.5(P < 0.05). During the follow-up, no complications such as infection, loosening, sinking and valgus were observed. Conclusion: Providing accurate osteotomy, effective correction of the force line, simple operation and satisfactory clinical effect, the PSI osteotomy guide plate is applicable for total knee arthroplasty with valgus knee.

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.

scholarly journals Early outcomes of posterior cruciate retaining primary total knee arthroplasty in patients of osteoarthritis in Indian population

2018 ◽  
Vol 4 (3) ◽  
pp. 463
Author(s):  
Sunil Kumar Dash ◽  
Sanket Mishra ◽  
Sumanyu Tripathy ◽  
Manish Sharma ◽  
Aurobinda Das
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Indian Population ◽  
Primary Total Knee Arthroplasty ◽  
Walking Distance ◽  
Cruciate Retaining ◽  
Functional Parameters ◽  
Total Knee ◽  
Primary Total Knee

<p class="abstract"><strong>Background:</strong> Total knee replacement arthroplasty today has become the final treatment option for patients with unsalvageable, severely arthritic, painful and deformed knees. In India the numbers of such surgeries are steadily on the rise with bulk of the patients being relatively younger group. Amongst several factors affecting the kinematics of knee, variations in surface geometry and the retention or sacrificing the posterior cruciate ligament is considered especially important. The role of the retaining a PCL on the demographic, clinical and functional parameters of a patient undergoing TKA remains controversial. The aim of the study was to evaluate the outcomes of cruciate retaining primary total knee arthroplasty in patients of osteoarthritis in relation to demographic, clinical and functional parameters.</p><p class="abstract"><strong>Methods:</strong> 20 knees from 12 patients of osteoarthritis including 8 females and 4 males in age group 45-80 years were operated with cruciate retaining implants. The pre and postoperative evaluations were done radiologicaly and clinically using new knee society score. Patients were followed up for minimum 1 year.<strong></strong></p><p class="abstract"><strong>Results:</strong> evaluations of patients revealed good postoperative improvements at subsequent follow up in comparison to preoperative scores. The average range of movement improved by 43.3 degree. The objective, patients satisfaction and functional score improved with scores of 89, 34 and 89.7 at 1 year follow up. The walking distance and staircase climbing, squatting scores also did well. Age did not seem to affect overall outcomes with males having slightly better postoperative scoring overall.</p><p class="abstract"><strong>Conclusions:</strong> In Indian population when the patient is young, high demanding, the retention of cruciate ligaments gives excellent postoperative functionality and objectivity and should be always considered as first choice surgery.</p>

scholarly journals Total knee arthroplasty with the least-constrained implant possible for type II valgus knee > 20°: a 3–14 years’ follow-up

Arthroplasty ◽  
2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Jiangdong Ren ◽  
Xiaogang Zhang ◽  
Wuhuzi Wulamu ◽  
Nuerailijiang Yushan ◽  
Abudousaimi Aaimaiti ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Valgus Knee ◽  
Type Ii ◽  
Total Knee
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