Midterm Outcome of the Duracon Total Knee Arthroplasty

Abstract

The Duracon TKA had good midterm clinical results with absence of patellofemoral complications.

Peak Knee Flexion Angles During Stair Descent in TKA Patients

“…Similar to TSK-scores, the level of pain reported in the present study was low and with little variance, and thus did not contribute to explain the observed smaller PKSD. Low pain was also in line with findings in other studies [7,22]. Nor did AKL explain reduced PKSD.…”

“…Although the present study did not have access to x-rays of the contralateral knees, it could still be proposed that there exists asymptomatic gonarthrosis limiting knee flexion [31]. As shown in other studies [4][5][6][7], TKA-subjects walked with smaller PKSD, although PPKF was sufficient both in the prosthetic knee and in the contralateral knee in order to descend stairs with similar knee flexion as controls. PPKF correlated across groups with PKSD and was the only factor that explained the variance in PKSD in the TKA-leg.…”

“…In posterior cruciate retaining knee prostheses a paradoxical forward slide instead of a normal rollback of the tibio-femoral contact point occurs with increasing flexion. This suggests that TKA related factors other than reduced ROM, may be responsible for reduced knee flexion in stair descent [7]. Also factors outside joint mechanics may be considered, such as weakness of the knee and hip muscles [11][12][13][14] Studies on level walking propose that asymmetrical gait after TKAsurgery is retained from the pre-surgery gait and characterized by a specific walking pattern, presumably for unloading the affected knee [1].…”

“…Although it is concluded that flexion in the prosthetic knee is reduced during stair descent [2,[4][5][6], the underlying mechanisms are uncertain. Although knee flexion is restricted due to the mechanics of the prosthesis [7], stair studies show that the range of motion (ROM) leaves a margin of 6°-16°, theoretically permitting sufficient knee flexion for normal stair descent [4][5][6]. There are, however also other qualities with TKA that may be important to consider, such as reduced or increased sagittal laxity in the prosthetic knee joint [8][9][10].…”

“…In posterior cruciate retaining knee prostheses a paradoxical forward slide instead of a normal rollback of the tibio-femoral contact point occurs with increasing flexion. This suggests that TKA related factors other than reduced ROM, may be responsible for reduced knee flexion in stair descent [7]. Also factors outside joint mechanics may be considered, such as weakness of the knee and hip muscles [11][12][13][14], fear of movement [15], reduced proprioception [16], leg length discrepancy [17], obesity [18][19][20], pain [7,21,22], time since TKA surgery [13,23], age [24], and habitual gait patterns [1].…”