scholarly journals The use of the constrained prosthesis in the difficult primary knee arthroplasty

2021 ◽  
Vol 64 (5) ◽  
pp. 11-15
Author(s):  
Vitalie Iacubitchii ◽  
◽  
Alexandru Betisor ◽  
Nicolae Erhan ◽  
◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Knee Prosthesis ◽  
Revision Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Bone Defects ◽  
Valgus Knee ◽  
Total Knee ◽  
Primary Total Knee

Background: The constrained knee prosthesis has the basic indication in revision arthroplasty, but the latest literature reveals that it takes place also in primary total knee arthroplasty in cases of knee osteoarthritis associated with major deformities. Material and methods: Present study is based on the surgical treatment, using the constrained knee prosthesis in the primary total knee arthroplasty, during 2019-2021, of 28 patients with knee osteoarthritis associated with severe deformities in varus or valgus, in the Big Joint Replacement Department, Clinical Hospital of Traumatology and Orthopedics, Chisinau. Results: In this study, the following criteria were evaluated: the type of deformity – valgus (10 cases) and varus (18 cases); the degree of deformation – for varus knees was on average 300 , and for valgus knee – 250 ; bone attrition – 11 cases with bone defects where it was necessary to use augmentations; affected side – in 19 cases the right knee was affected and 9 cases the left one; the women/men ratio was 4/1; the mean age of the patients was 67.5 years; average duration of the intervention – 140 minutes; in 5 cases a lateral para-patellar approach was performed, of which 2 cases with tibial tuberosity osteotomy; complications – 1 case with intra-operative periprosthetic fracture and 2 cases with superficial infections of the operated joints. Conclusions: Osteoarthritis of the knee progresses rapidly, leading to severe deformities, significant bone defects and joint instability, which are indications to use the constrained prosthesis in the primary total knee arthroplasty, long-term follow-up is necessary to obtain the last conclusion, but from this study the constrained knee prosthesis like primary implant for special indication had promising results.

Early Clinical and Radiological Outcomes of the Metaphyseally Fixed Totally Stabilized Knee Prosthesis in Primary Total Knee Arthroplasty

2019 ◽  
Vol 33 (07) ◽  
pp. 678-684 ◽  
Author(s):  
Fahad Hossain ◽  
Sujith Konan ◽  
Babar Kayani ◽  
Christina Kontoghiorghe ◽  
Toby Barrack ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Prosthesis ◽  
Oxford Knee Score ◽  
Primary Total Knee Arthroplasty ◽  
Primary Tkas ◽  
Total Knee ◽  
The Mean ◽  
Primary Total Knee

AbstractThe use of valgus–varus constrained (VVC) implant designs in primary total knee arthroplasty (TKA) is considered in situations of severe deformities, bone loss, and inadequate soft tissue balance. It is not known whether the use of such prosthesis designs may predispose to reduced function owing to its constraining design. The components are usually implanted with diaphyseal stem extensions to dissipate the increased forces. The totally stabilized (TS) implant is a contemporary VVC design with metaphyseal fixation only. It has a conforming articulation with increased rotational freedom compared with conventional VVC designs. The aim of this study was to assess whether the use of the contemporary TS implant with its metaphyseally fixed components would be associated with inferior outcomes compared with conventional standard primary posterior stabilized (PS) implants. We reviewed 38 consecutive complex primary TKAs performed using the metaphyseally fixed TS implant and 76 matched patients receiving primary PS TKA, at a minimum follow-up of 24 months. The mean follow-up was 61.1 months (24–102). Only patients with osteoarthritis were included. Clinical outcome was assessed using range of motion (ROM) and Oxford knee score (OKS). Radiographic assessment was performed using the femorotibial angle (FTA) at 6 weeks followed by assessment of bone–implant interface lucencies at final follow-up. There were no major early postoperative complications. The mean postoperative ROM in the TS and PS groups were 114.1 and 112.0, respectively. There was no difference in the mean ROM and OKS between the two groups. The mean FTA for patients in both groups was within 3° of the expected. There was no evidence of progressive lucencies or implant migration at final follow-up. The metaphyseally fixed TS knee design achieves comparable short-term functional outcomes when compared with conventional PS designs in primary knee arthroplasty. Long-term follow-up studies are required to assess survivorship.

scholarly journals Giant Solitary Cyst at the Site of Knee Osteoarthritis: Treatment with a Synthetic Resorbable Bone Graft Substitute and Primary Total Knee Arthroplasty

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Andreas Thiery ◽  
Octavian Tapos ◽  
Konstantinos Anagnostakos
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Bone Graft ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Bone Graft Substitute ◽  
Bone Lesions ◽  
X Rays ◽  
Total Knee ◽  
Primary Total Knee

A 48-year-old male patient presented in our department with knee osteoarthritis and a giant cystic lesion of the lateral femoral condyle. Bone biopsy of the lesion was performed. Histopathological examination confirmed the presence of a solitary bone cyst. The patient was treated by curettage of the cyst, filling with a synthetic resorbable bone graft substitute (Cerament™), and primary, cruciate-retaining total knee arthroplasty. 4 months after surgery, complete osseointegration of the bone graft substitute was evident on X-rays. The use of modern bone graft substitutes might be a novel alternative to other established techniques in the management of large bone lesions, even at the site of primary total knee replacement.

Evaluation of surgical technique of screws and bone cement in R and C tibial bone defects correction of primary Total Knee Arthroplasty

2021 ◽  
pp. 1-6
Author(s):  
Shouye Hu ◽  
Chao Lu ◽  
Zhi Yang ◽  
Kan Peng
Keyword(s):  
Total Knee Arthroplasty ◽  
Surgical Technique ◽  
Bone Cement ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Bone Defects ◽  
Tibial Bone ◽  
Total Knee ◽  
Primary Total Knee

Objective: The use of screws and cement is a well–known technique for repairing proximal tibial bone defects during primary total knee arthroplasty (TKA). The purpose of this study was to summarize our experience of using of screws and cement for R and C tibial bone defects in primary TKA.

Primary total knee arthroplasty in the valgus knee

2001 ◽  
Vol 16 (6) ◽  
pp. 721-729 ◽  
Author(s):  
Christopher L. Peters ◽  
R.Alexander Mohr ◽  
Kent N. Bachus
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Valgus Knee ◽  
Total Knee ◽  
Primary Total Knee

scholarly journals Fungal Periprosthetic Infection after Total Knee Arthroplasty (Case Report and Review)

2019 ◽  
Vol 25 (4) ◽  
pp. 134-140
Author(s):  
S. A. Bozhkova ◽  
P. P. Ivanov ◽  
E. A. Zemlyanskaya ◽  
N. N. Kornilov
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Periprosthetic Infection ◽  
Revision Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Infection Process ◽  
Second Stage ◽  
Total Knee ◽  
Revision Prosthesis ◽  
Primary Total Knee

The rate of periprosthetic infection (PJI) following primary total knee arthroplasty ranges from 0,5 to 6%, while after the revision arthroplasty PJI rate grows up to 13,6%. Despite the fact that PJI is more often caused by gram-positive microorganisms, the treatment of patients induced by gram-negative pathogens and fungi is the most complex and associated with the higher recurrence rate. This paper presents a positive two-stage treatment of a patient with fungal periprosthetic infection with a review of current medical literature. Revision, sanation of infection site and implantation of articulating antibacterial spacer was performed in the first stage of treatment. The second stage, which was the implantation of a revision prosthesis, followed in 6 months after removal of infection nidus. Subsequently the authors obtained good functional outcomes and stopping the infection process.

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