High-Flexion Posterior-Stabilized Total Knee Prosthesis: Is It Worth the Hype?

Jain, Sanjeev; Pathak, Aditya C; Kanniyan, Kalaivanan; Kulkarni, Sourabh; Tawar, Sandeep; Mane, Prashant

doi:10.5792/ksrr.2013.25.3.100

Cited by 20 publications

(16 citation statements)

References 43 publications

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“…We can evidently not be satisfied with such results in view of the growing proportion of functionally demanding and younger patients. It is estimated that 50% of TKA patients will be less than 65 years of age in the very near future [19]. Navigation is one of the factors that can lead to improved functional outcomes as shown by Choong et al [20].…”

Section: Current Resultsmentioning

confidence: 99%

Computer Assisted Knee Replacement Surgery: Is the Movement Mainstream?

Picard

Clarke²,

Deep

et al. 2014

Orthop Muscul Syst

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The first computer-assisted Total Knee Arthroplasty (TKA) was performed in 1997. The FDA approved computer assisted knee arthroplasty systems used in the early 2000s. Since then, surgeons and institutions all over the world have gradually adopted the technology. While the computer holds an importance place in the majority of workspaces across all industries, computer-assisted surgical technique has yet to become the preferred tool of the orthopaedic surgeon. Why has "e-instrumentation" not yet substituted conventional instrumentation in TKA orthopaedic surgery?In this article, we argue that main reasons which oppose the use of this technology are based on inaccurate or misleading observations. We isolated the factors likely to explain such opposition to this innovation: current results of total knee replacement, surgeon age, operative time, system ergonomics, cost for users, and cost for suppliers and "disruptive" innovations. Other factors such as surgeon habits, hospital environment and available assistance for support, although relevant, are not discussed. We assessed the advantages and drawbacks, costs and benefits of this technology to assess whether or not this opposition is justified. Finally, we explored the reasons why such a technology may impel surgeons to use this technique or any "related technologies" in the future.The main factors limiting TKA navigation spreading amongst orthopaedic surgeons are ergonomics and economics. Other factors, such as current TKA outcomes and surgeon's age are fallacious arguments in the rebuttal of CAS system use. Computer assisted knee arthroplasty surgery is not yet mainstream, but TKA will not escape technological progress.

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Section: Current Resultsmentioning

confidence: 99%

Computer Assisted Knee Replacement Surgery: Is the Movement Mainstream?

Picard

Clarke²,

Deep

et al. 2014

Orthop Muscul Syst

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“…In addition, the larger posterior condyle of the femoral component decreases the risk of impingement between the posterior cortex of the femur and the polyethylene insert 8) . The new prosthesis has a modified cam and post mechanism with increased jump distance to avoid dislocation under deep flexion angles 9) . It also has a longer trochlear groove for improved patellar tracking.…”

Section: Introductionmentioning

confidence: 99%

Two- to Four-Year Follow-up Results of Total Knee Arthroplasty Using a New High-Flexion Prosthesis

Kim

Koh

Jang

et al. 2016

Knee Surg Relat Res

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PurposeThe purpose of this study was to evaluate minimum 2-year follow-up results of total knee arthroplasty (TKA) performed using a new high-flexion prosthesis design (LOSPA).Materials and MethodsThe 2- to 4-year results of 191 consecutive TKAs (177 patients) with the LOSPA posterior-stabilized prosthesis were evaluated. The patients were assessed clinically and radiographically using the Knee Society scoring system (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).ResultsThe mean range of motion (ROM) increased significantly from 117.4° (range, 75° to 140°) preoperatively to 126.7° (range, 80° to 144°) postoperatively (p<0.001). The mean KSS and WOMAC scores improved significantly from 121.4 (range, 42 to 185) and 56.1 (range, 23 to 88) preoperatively to 174.0 (range, 130 to 200) and 16.4 (range, 0 to 85) postoperatively, respectively (both, p<0.001). One knee required revision for deep infection. No knee had aseptic loosening or osteolysis. Radiolucent lines were noted in 15 knees (7.9%).ConclusionsThe new high-flexion total knee prosthesis resulted in no early aseptic loosening of the component and improved postoperative ROM comparable to other high-flexion TKA prostheses at 2- to 4-year follow-ups.

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“…The loosening of the femoral component leads to early revisions. 22 A study conducted in the Asian population showed that high flexion design was associated with lower survival and femoral component loosening which required revision of the procedure. Seventy-two patients with Nexgen LPS-flex fixed TKAs were prospectively followed up for 18 months to determine the probability of survival using revision as the endpoint.…”

Section: Discussionmentioning

confidence: 99%

Increasing range of motion in total knee replacement using novel patellar resection technique

Suryavanshi¹

2020

Int Surg J

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Background: Total knee arthroplasty (TKA) is a surgical procedure designed to alleviate pain and improve function in patients suffering from osteoarthritis. Range of motion is one of the most important factors for patient satisfaction after total knee replacement. The purpose of this study was to assess the effectiveness of a new TKA technique involving patellar resection to enable increased flexion of the knee joint.Methods: Eighty-four patients suffering from osteoarthritis with an indication for conducting TKA underwent the novel procedure. Pre-operative and post-operative flexion measurements were assessed.Results: Mean age of patients participating in this study was 62 years. Males and females were 63% and 37 % of total population respectively. The mean pre-operative and post-operative flexion measurements were 97.39±3.33 º and 131.35±4.27 respectively. The mean in flexion measurements was improved by 33.95±5.30 º (p<0.05). The joint was kinematically stable during full flexion, mid-flexion, and extension.Conclusions: The novel patellar resection technique can be beneficial for the patients. They can able to follow their native lifestyle and perform their daily activities without any hindrance. The mean increase in the range of flexion was 33.95±5.30 º (ranged 30-35 º, p<0.05). This technique allowed patients to have a greater range of flexion as compared to standard and high flexion designs.

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High-Flexion Posterior-Stabilized Total Knee Prosthesis: Is It Worth the Hype?

Cited by 20 publications

References 43 publications

Computer Assisted Knee Replacement Surgery: Is the Movement Mainstream?

Computer Assisted Knee Replacement Surgery: Is the Movement Mainstream?

Two- to Four-Year Follow-up Results of Total Knee Arthroplasty Using a New High-Flexion Prosthesis

Increasing range of motion in total knee replacement using novel patellar resection technique

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