Comparison of the Clinical Results of Patients who Underwent PCL-retaining and PCL-substituting Total Knee Arthroplasty

Abstract Background This study aimed to compare the short-term clinical results of slight femoral under-correction with neutral alignment in patients with preoperative varus knees who underwent total knee arthroplasty. Methods The medical records and imaging data were retrospectively collected from patients who had undergone total knee arthroplasty in our hospital from January 2016 to June 2019. All patients had varus knees preoperatively. Upon 1:1 propensity score matching, 256 patients (256 knees) were chosen and divided into a neutral alignment group (n=128) and an under-correction group (n=128). The patients in the neutral group were treated with the neutral alignment. In the under-correction group, the femoral mechanical axis had a 2° under-correction. The operative time, tourniquet time and the length of hospital stay in the two groups were recorded. The postoperative hip-knee-ankle angle, frontal femoral component angle and frontal tibial component angle were measured. Patient-reported outcome measures were also compared. Results The operative time, tourniquet time and the length of hospital stay in the under-correction group were significantly shorter than the neutral alignment group (P<0.05). At the 2-year follow-up, the under-correction group had a larger varus alignment (P<0.05) and a larger frontal femoral component angle (P<0.05), and the frontal tibial component angles of the two groups were comparable. Compared with the neutral alignment group, the slight femoral under-correction group had significantly better patient-reported outcome measures scores (P<0.05). Conclusion For varus knees treated with total knee arthroplasty, alignment with a slight femoral under-correction has advantages over the neutral alignment in terms of the shorter operative time and better short-term clinical results. Level of evidence III

Download Full-text

Clinical Results of Total Knee Arthroplasty by Using Improved Cement Technique by Interposing Hydroxyapatite Granules

Key Engineering Materials - Bioceramics 19 ◽

10.4028/0-87849-422-7.819 ◽

2007 ◽

pp. 819-822

Author(s):

Sok Chol Kim ◽

Hironobu Oonishi ◽

Hiroyuki Oonishi ◽

Hirotsugu Ohashi

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Clinical Results ◽

Total Knee

Download Full-text

Bicompartmental Knee Arthroplasty (BKA) in comparison to unicompartmental (UKA), Patellofemoral (PFA) ans total knee arthroplasty (TKA) – Early Clinical Results

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00234 ◽

2019 ◽

Vol 7 (6_suppl4) ◽

pp. 2325967119S0023

Author(s):

Johannes Holz ◽

Stefan Schneider ◽

Ansgar Ilg ◽

Rene Kaiser

Keyword(s):

Total Knee Arthroplasty ◽

Total Knee Replacement ◽

Knee Replacement ◽

Knee Arthroplasty ◽

Patient Reported Outcomes ◽

Clinical Results ◽

Single Center ◽

Patient Reported ◽

Total Knee ◽

Bicompartmental Arthroplasty

Aims and Objectives: The purpose was to evaluate the clinical outcomes of patients with knee osteoarthritis treated with bicompartmental arthroplasty (BKA) in comparison to unicompartmental (UKA), patellofemoral (PFA) and total knee arthroplasty (TKA) in a single center. Materials and Methods: This is a prospective study analyzing a consecutive series of 396 patients from two surgeons in a single center. In 191 men and 205 women either partial or total knee replacement were performed. Their mean age at surgery was 63±6,85 years and mean BMI 29,55±5,00 kg/m2. In 238 patients UKA, in 125 TKA, in 21 PFA and in 11 patients BKA was performed. Implants were cemented and made of cobalt chrome in partial knee and zirconium oxide in total knee replacement. Demographics and patient reported outcomes (VAS, KOOS, Oxford Knee Score (OKS)) were collected preoperatively and 3,6 and 12 months postoperatively. A total of 202 patients have thus far completed the 12 months follow-up time point. Results: All mean KOOS and OKS scores improved significantly 1 year after surgery (p<0.05). Mean preoperative aggregated KOOS improved from 49,0±14,1 to 74,3±17,8 in UKA, from 44,1±12,9 to 67,5±9,4 in PFA, from 46,1±15,1 to 71,0±14,8 in TKA and from 45,7±13,8 to 72,6±9,7 in BKA (p<0.05). Mean preoperative aggregated OKS improved from 25,1±7,6) to 38,5±9,7 in UKA, from 23,0±7,6 to 36,8±3,8 in PFA, from 23,4±8,2 to 37,3±8,1 in TKA and from 22,9±9,6 to 37,0±1,5 in BKA (p<0.05). The mean pain level (VAS)decreased from pre-treatment to 12 months after surgery in UKA from 5,5 to 1,6, in PFA from 6,1 to 2,5, in TKA from 6,0 to 1,9 and in BKA from 6,6 to 2,6. One patient (0.4%) underwent revision (at 3 month for inlay dislocation). Conclusion: This study shows excellent early clinical results of patients treated with unicompartmental, bicompartmental and total knee arthroplasty. Adherence to strict indications lead to a significant improvement of patient reported outcomes and a low revision rate one year postoperatively. The reported results for BKA are comparable to those of patients treated with unicompartmental arthroplasty. We conclude that bicompartmental arthroplasty is a safe and reliable surgery for patients with bicompartmental osteoarthritis.

Download Full-text

Keio Total Knee Arthroplasty: Concept, Design, and Clinical Results

Total Knee Replacement ◽

10.1007/978-4-431-68075-8_7 ◽

1988 ◽

pp. 83-91

Author(s):

F. Iseki ◽

T. Takeda ◽

K. Fujikawa

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Clinical Results ◽

Concept Design ◽

Total Knee

Download Full-text

The Influence of Implant Position on Final Clinical Outcome and Gait Analysis after Total Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0038-1669913 ◽

2018 ◽

Vol 32 (09) ◽

pp. 891-896

Author(s):

Jarosław Jabłoński ◽

Marcin Sibiński ◽

Michał Polguj ◽

Jacek Kowalczewski ◽

Dariusz Marczak ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Femoral Component ◽

Knee Arthroplasty ◽

Clinical Results ◽

Functional Score ◽

X Ray ◽

Gait Parameters ◽

Total Knee ◽

One Year ◽

The Impact

AbstractThe aim of the study was to evaluate the impact of implant component alignment on objective and subjective outcomes after total knee arthroplasty (TKA). The rotation of the femoral component and its influence on the final results were also examined. After exclusion, the study examined 102 patients (mean age, 66.28 years; range, 51–79 years) who had undergone unilateral TKA. All of the operative procedures were performed by one surgeon with one type of implant. One year after the operation, improvements in Knee Society's Knee Scoring System, functional score, Western Ontario and McMaster Universities Osteoarthritis Index, and Visual Analog Scale were observed; however, none showed a significant correlation with any of the parameters analyzed by X-ray or computed tomography (CT) (α, β, γ, δ angles and posterior condylar angle [PCA]). Significant improvements were found for the vast majority of the parameters used for gate analysis at the final follow-up. Significant correlations were found between PCA angle and differences in stance phase, swing phase of the operated limb, and step width (all p = 0.03). No other significant relationships were found between gait parameters and indicators measured by X-ray and CT. None of the analyzed radiographic parameters, including rotation of the femoral component, correlated with final clinical results. Neither femoral internal rotation of 3° to 6°, nor rotation of 0° ± 3° or 0° ± 6° influenced the outcome. One year after TKA, a significant improvement was observed in both functional and gait parameters.

Download Full-text