Outcomes of 447 SCORE® highly congruent mobile-bearing total knee arthroplasties after 5–10years follow-up

Abstract

Level IV continuous retrospective study.

Does computer-assisted surgery influence survivorship of cementless total knee arthroplasty in patients with primary osteoarthritis? A 10-year follow-up study

“…CAS has been developed in TKA to minimise outliers in component positioning and to improve final mechanical alignment and soft tissue balance [3, 4, 9, 10, 27, 31, 40]. Châtain et al [9] demonstrated that CAS enabled a more accurate soft tissue balance achievement and restoration of a neutral limb alignment with improved clinical scores when compared to the conventional mechanical technique.…”

“…CAS has been developed in TKA to minimise outliers in component positioning and to improve final mechanical alignment and soft tissue balance [3, 4, 9, 10, 27, 31, 40]. Châtain et al [9] demonstrated that CAS enabled a more accurate soft tissue balance achievement and restoration of a neutral limb alignment with improved clinical scores when compared to the conventional mechanical technique. In addition, reporting the results issued from the Australian Orthopaedic Association National Joint Replacement Registry, de Steiger et al [35] emphasised that CAS reduced the overall rate of TKA revision as well as the rate of revision for loosening/lysis, particularly in patients less than 65 years of age in which higher rates of revision due to wear‐related issues were reported in the literature.…”

“…However, the influence of CAS on TKA clinical outcome and survivorship at long‐term follow‐up remains debated. Several studies and meta‐analyses have demonstrated that positioning the TKA components within 3° of the neutral mechanical axis in the post‐operative alignment of the knee could reduce the risks of early PE wear, component loosening and implant mechanical failure [3, 4, 9, 10, 27, 31]. Interestingly, Parratte et al [24] demonstrated that achievement of a post‐operative neutral mechanical axis alignment of 0° ± 3°, as is currently obtained with contemporary CAS systems, could not substantially improve TKA survivorship at long‐term follow‐up compared to TKA that missed this goal.…”

“…Interestingly, Parratte et al [24] demonstrated that achievement of a post‐operative neutral mechanical axis alignment of 0° ± 3°, as is currently obtained with contemporary CAS systems, could not substantially improve TKA survivorship at long‐term follow‐up compared to TKA that missed this goal. This result suggests that the importance of a post‐operative neutral mechanical axis could be relative compared to ligament and soft tissue balance [7, 9]. Balanced soft tissue and ligament are essential for optimal knee kinematics, and over‐tensioning of ligaments could lead to reduced range of motion and increase the likelihood of flexion deformity and medial–lateral instability [37].…”

Increased valgus laxity in flexion with greater tibial resection depth following total knee arthroplasty

“…The effect of tibial resection on valgus angulation under load was studied for tibial cuts made sequentially on each specimen at 6mm, 10mm, 14mm, 18mm and 24mm. Computer navigation (Amplitude® navigation system with a Polaris® infrared camera « Amplivision® » [3]) was used to position the tibial cutting guide at the selected depth, and to result in a cut with a posterior slope of 0° and a frontal tibial angulation at 90° to the tibial mechanical axis. Trackers for the navigation system were applied to the femoral and tibial diaphysis.…”