High-flexion implants in primary total knee arthroplasty: A meta-analysis

Gandhi, Rajiv; Tso, Peggy; Davey, J Roderick; Mahomed, Nizar N.

doi:10.1016/j.knee.2008.08.001

Cited by 42 publications

(36 citation statements)

References 19 publications

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“…Some cruciate-retaining HF TKA designs include a chamfered medial border of the lateral femoral condyle to provide clearance to the posterior cruciate ligament in high flexion [22]. Despite the improved knee kinematics in high flexion introduced by the previously mentioned changes, it is still unclear whether these HF designs will actually improve clinical ROM and function [6]. It is also questionable whether they provide better flexion to all patients or if they benefit only a selected group of patients with high preoperative flexion [18].…”

Section: Discussionmentioning

confidence: 99%

“…The literature results comparing HF and PS TKA designs continue to be inconclusive and are probably design and surgeon dependent [6,10,13,18,20,21,28,29,38]. Table 5 outlines results from different studies comparing PS and HF TKA designs.…”

Section: Discussionmentioning

confidence: 99%

“…In a randomised controlled trial of 100 patients receiving a Genesis 2 TKA with a standard or HF insert, the same authors failed to demonstrate a clinically significant difference between the two groups [20]. A recent metaanalysis by Gandhi et al concluded that HF implant designs improve the overall ROM compared with traditional implants but offer no clinical advantage in primary TKA [6]. In a systematic literature review focusing on outcomes after HF TKA, Murphy et al found that there was insufficient evidence to support the view that these new TKA designs improved ROM or functional performance [24].…”

Section: Discussionmentioning

confidence: 99%

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Range of motion and function are similar in patients undergoing TKA with posterior stabilised and high-flexion inserts

Malik

Salas²,

Ari

et al. 2009

International Orthopaedics (SICOT)

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It is debatable whether high-flexion (HF) total knee arthroplasty (TKA) designs will improve postoperative flexion and function or will diminish the need for manipulation under anaesthesia (MUA). We retrospectively analysed range of motion (ROM), flexion, Knee Society Score (KSS), and rate of MUA in a consecutive group of patients who underwent TKA with a conventional posterior stabilised (PS) insert or an HF insert using identical surgical technique, implant design, and postoperative care. Fifty TKAs with a standard PS insert were matched for patient's age, gender, preoperative ROM, and KSS with 50 TKA performed with an HF insert. The patient's ROM and KSS were evaluated at six weeks, four months, and one year postoperatively. The outcome variables (flexion, ROM, KSS, and manipulation rate) in both groups were compared using the generalised estimating equations method. A second analysis of patients with preoperative flexion ≥120°was performed. The ROM, flexion, and patient-reported KSS was similar in both groups at each time period. The rate of MUA was also similar. Patients with a preoperative ROM of at least 120°showed similar results. Our study found that one year after surgery, patients who underwent TKA with a PS or an HF insert achieved similar flexion, ROM, and function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Range of motion and function are similar in patients undergoing TKA with posterior stabilised and high-flexion inserts

Malik

Salas²,

Ari

et al. 2009

International Orthopaedics (SICOT)

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“…[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] En una revisión sistemática conducida por Murphy y cols., que incluyó nueve estudios y 399 prótesis de alta flexión en 370 pacientes, focalizada en estudiar los resultados de las prótesis de alta flexión, se comunica la falta de evidencia para determinar que las prótesis de alta flexión mejorarían el rango de movilidad y el desempeño funcional de los pacientes. 38 Un metanálisis publicado en 2009 muestra resultados a favor de las prótesis de alta flexión comparadas con las convencionales, a diferencia de lo publicado en un metanálisis de 2011.…”

Section: Discussionunclassified

“…[14][15][16] La literatura es amplia y controvertida en este tema y los trabajos publicados sobre pacientes con ATR de alta flexión difieren respecto de los resultados logrados en el rango de movilidad. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] El objetivo de este trabajo comparativo fue analizar los resultados funcionales y el rango de movilidad de la rodilla entre tres grupos de pacientes con ATR, utilizando dos diseños de prótesis de alta flexión y un diseño convencional. Cuarenta y dos pacientes fueron tratados con una próte-sis convencional (Zimmer® NexGen® LPS).…”

Section: Introductionunclassified

Rango de movilidad y resultados funcionales en tres diseños diferentes de artroplastia de rodilla primaria. Estudio Comparativo. [Range of motion and functional results in three different designs of total knee arthroplasty].

Bonifacio

Paz

Yacuzzi

et al. 2016

Rev. Asoc. Arg. Ort. y Traumatol

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264 ResumenIntroducción: El objetivo de este trabajo fue analizar los resultados funcionales y el rango de movilidad entre tres grupos de pacientes con ar troplastia total de rodilla: dos con prótesis de alta flexión y otro con un diseño convencional. Materiales y Métodos: Sesenta y cuatro pacientes fueron operados con una prótesis total de rodilla Zimmer® NexGen® y 34, con una Optetrack® de alta flexión. Luego de la exclusión de pacientes, 22 (grupo A) fueron tratados con un diseño Zimmer® de alta flexión; 21 (grupo B), con una prótesis Zimmer® convencional y 25 (grupo C), con una prótesis Optetrack® PS. La evaluación funcional se realizó con el Knee Society Score, el Western Ontario and McMaster Universities Osteoarthritis index y la escala analógica visual. Resultados: En el posoperatorio, el promedio de flexión máxima subió de 99° a 113º en el grupo A, con un aumento promedio de 14º; de 106° a 118º en el grupo B, con una ganancia promedio de 12º y de 110° a 111° en el grupo C, con una ganancia de 1°. Los resultados funcionales evaluados con los dos puntajes mejoraron en los tres grupos. Conclusiones: Las evaluaciones clínicas funcionales son favorables en los tres diseños evaluados. Este estudio muestra que no hay diferencias significativas en la flexión final lograda y los resultados funcionales entre los dos primeros diseños; sin embargo, estos son significativamente superiores al diseño del tercer grupo luego de un año de seguimiento.Palabras clave: Prótesis total de rodilla; prótesis de alta flexión; prótesis convencionales; rango de movilidad. Nivel de Evidencia: IIIRange of motion and functional results in three different designs of total knee arthroplasty. Comparative study Abstract Introduction: The purpose of this comparative study was to analyze functional results and the range of motion of the knee among three groups of patients with total knee arthroplasty using high-flex prosthesis (in two groups) and a conventional design (one group). Methods: Sixty-four patients were surgically treated with total knee arthroplasty using a Zimmer® NexGen® prosthesis, and 34 patients received a high-flex Optetrack® design. After exclusion of patients, 22 patients (group A) were treated with a high-flex Zimmer® NexGen® design, 21 patients (group B) were treated with a conven tional implant, and 25 patients (group C) received a high-flex PS Optetrack® prosthesis. Functional evaluation was performed with the Knee Society Score, the Western Ontario and McMaster Universities Osteoarthritis index, and a visual analogue scale. Results: Mean post-surgical maximum flexion increased from 99° to 113º in group A, with an average increase of 14º, from 106° to 118º in group B, with an average gain of 12º, and from 110 to 111° in group C, with an average increase of 1°. Functional results assessed with both scores showed improvements in all three groups. Conclusions: The functional and radiographic outcomes were favorable in the three designs. This study suggests that there are no signi ficant differences in the final flexion ...

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