scholarly journals The role of joint line position and restoration of posterior condylar offset in revision total knee arthroplasty : a systematic review of 422 revision knees arthroplasty

2021 ◽  
Vol 87 (3) ◽  
pp. 453-460
Author(s):  
Hany Elbardesy ◽  
André McLeod ◽  
Rehan Gul ◽  
James Harty
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Joint Line ◽  
Level Of Evidence ◽  
Posterior Condylar Offset ◽  
Upper Limit ◽  
Posterior Condylar ◽  
Total Knee

The aim of this systematic review was to evaluate the evidence on reservation of Posterior Femoral Condylar Offset (PFCO) and Joint Line (JL) after Revision Total Knee Arthroplasty (RTKA) for im- proved functional outcomes. A comprehensive search of PubMed, Medline, Cochrane, CINAHL, and Embase databases was conducted, with papers published from the inception of the database to October 2020 included. All relevant articles were retrieved, and their bibliographies were hand searched for further references on Posterior condylar offset and revision total knee arthroplasty. The search strategy yielded 28 articles. After duplicate titles were excluded, abstracts and full text were reviewed. Nine studies were assessed for eligibility, four studies were excluded because they did not fully comply with the inclusion criteria. Six articles were finally included in this systematic review. Based on this systematic review restoration of the JL and PFCO in RTKR is associated with a significant improvement in the post-operative range of motion, KSS, OKS, patellar function, and SF-36. Reservation of JL should be a major consideration when undertaking RTKA. Of note, increasing PFCO to balance the flexion gap while maintaining joint line should be well assessed intra-operatively. The upper limit of the PFCO that widely accepted is up to 40 % greater than that of the native knee. 4 mm is the upper limit for JL restoration. Level of evidence III.

Influence of stem length on component flexion and posterior condylar offset in revision total knee arthroplasty

The Knee ◽  
2018 ◽  
Vol 25 (3) ◽  
pp. 480-484 ◽  
Author(s):  
Max Ettinger ◽  
Peter Savov ◽  
Omar Balubaid ◽  
Henning Windhagen ◽  
Tilman Calliess
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Stem Length ◽  
Posterior Condylar Offset ◽  
Posterior Condylar ◽  
Total Knee

Aseptic Loosening of Porous Metaphyseal Sleeves and Tantalum Cones in Revision Total Knee Arthroplasty: A Systematic Review

2020 ◽  
Author(s):  
Ryan P. Roach ◽  
Andrew J. Clair ◽  
Omar A. Behery ◽  
Savyasachi C. Thakkar ◽  
Richard Iorio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Aseptic Loosening ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Search Terms ◽  
Mesh Terms ◽  
Total Knee ◽  
Meta Analyses ◽  
Revision Tkas

AbstractBone loss often complicates revision total knee arthroplasty (TKA). Management of metaphyseal defects varies, with no clearly superior technique. Two commonly utilized options for metaphyseal defect management include porous-coated metaphyseal sleeves and tantalum cones. A systematic review was conducted according to the international Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We combined search terms “Total knee arthroplasty” AND/OR “Sleeve,” “Cone” as either keywords or medical subject heading (MeSH) terms in multiple databases according to PRISMA recommendations. All retrieved articles were reviewed and assessed using defined inclusion and exclusion criteria. A total of 27 studies (12 sleeves and 15 cones) of revision TKAs were included. In the 12 studies on sleeve implantation in revision TKAs, 1,617 sleeves were implanted in 1,133 revision TKAs in 1,025 patients. The overall rate of reoperation was 110/1,133 (9.7%) and the total rate of aseptic loosening per sleeve was 13/1,617 (0.8%). In the 15 studies on tantalum cone implantation in revision TKAs, 701 cones were implanted into 620 revision TKAs in 612 patients. The overall rate of reoperation was 116/620 (18.7%), and the overall rate of aseptic loosening per cone was 12/701 (1.7%). Rates of aseptic loosening of the two implants were found to be similar, while the rate of reoperation was nearly double in revision TKAs utilizing tantalum cones. Variability in the selected studies and the likely multifactorial nature of failure do not allow for any definitive conclusions to be made. This review elucidates the necessity for additional literature examining revision TKA implants.

scholarly journals A Useful Radiologic Method for Preoperative Joint-line Determination in Revision Total Knee Arthroplasty

2009 ◽  
Vol 468 (5) ◽  
pp. 1279-1283 ◽  
Author(s):  
Jose Romero ◽  
Burkhardt Seifert ◽  
Olaf Reinhardt ◽  
Oliver Ziegler ◽  
Oliver Kessler
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Joint Line ◽  
Total Knee

Clinical and Radiographic Analysis of Accurate Restoration of the Joint Line in Revision Total Knee Arthroplasty

2006 ◽  
Vol 21 (8) ◽  
pp. 1154-1162 ◽  
Author(s):  
Aaron A. Hofmann ◽  
Stephen M. Kurtin ◽  
Steve Lyons ◽  
Amie M. Tanner ◽  
Michael P. Bolognesi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Joint Line ◽  
Radiographic Analysis ◽  
Total Knee

Does Posterior Condylar Offset Affect Clinical Results following Total Knee Arthroplasty?

2017 ◽  
Vol 31 (08) ◽  
pp. 754-760 ◽  
Author(s):  
Ryan Degen ◽  
Jacob Matz ◽  
Matthew Teeter ◽  
Brent Lanting ◽  
James Howard ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Outcome Measures ◽  
Knee Arthroplasty ◽  
Short Form ◽  
Clinical Results ◽  
Patient Reported Outcome Measures ◽  
Posterior Condylar Offset ◽  
Patient Reported ◽  
Posterior Condylar ◽  
Total Knee

AbstractTotal knee arthroplasty (TKA) is an effective, durable treatment for knee osteoarthritis. However, a subset of patients experiences incomplete pain relief and ongoing dysfunction. Posterior condylar offset (PCO) has previously been shown to be associated with postoperative range of motion (ROM) following TKA; however, an association with patient-reported outcome measures (PROMs) has not been established. The purpose of this study was to evaluate the association between PCO and postoperative ROM and PROMs. A retrospective review of 970 posterior-stabilized single design TKAs was performed. Preoperative and postoperative radiographs were analyzed to measure the change in PCO and anteroposterior (AP) femoral dimension. Clinical outcome measures, including Short Form-12 physical and mental component summaries, Western Ontario and McMaster Universities Arthritis Index, and Knee Society Score were reviewed to determine if these were influenced by changes in PCO and AP dimension. PCO was increased by more than 3 mm in 15.1%, maintained (within 3 mm) in 59.6%, and decreased by more than 3 mm in 25.3% of patients. Comparing between these groups, there were no significant differences in postoperative ROM or PROM. AP dimension increased in 24.4%, maintained in 47.8%, and decreased in 27.8%. Similarly, there were no significant differences in ROM or PROM between these groups. Spearman's correlation analyses failed to identify an association between PCO and ROM or PROMs. In conclusion, increasing or decreasing PCO or AP femoral dimension with this PS TKA design did not significantly affect postoperative ROM or PROM. Similarly, maintenance of PCO within one implant size with this system compared with optimal sizing had no deleterious effect on TKA outcomes.

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