Posterior-stabilized total knee arthroplasty: a matched pair analysis of a classic and its evolutional design

Abstract

BackgroundTotal knee arthroplasty (TKA) designs continue to be modified to optimize patient's outcome. This study was designed to compare clinical and radiological results of classic worldwide used TKA posterior-stabilized (PS) design to those of its recent evolution.MethodsA consecutive group of 100 patients undergoing TKA using a classic cemented fixed-bearing PS TKA system was matched by age, gender, body max index to 100 patients having the newer cemented fixed-bearing PS design, both by the same manufacturer. Patients were assessed preoperatively, at 12 months and at 24 months minimum follow-up (range, 24-46) in a standard prospective fashion. The outcome assessments used were the Oxford Knee Score, the Knee Society Score, range of motion, and a satisfaction survey. A 2-sample t test comparing the 2 groups was performed.ResultsNo patients were lost at follow-up. At 2-year follow-up, differences in clinical and radiological Knee Society Score (P = .09), Oxford Score (P = .08), and overall satisfaction rate did not reach statistical significance. Implant group 2 showed a statistically significant decrease in postoperative anterior knee pain (P = .006). At final follow-up, 16% of group 1 knees achieved > 130° flexion compared with 37% in group 2 (P = .0009). There were 2 revisions for any reason in group 1 and none in group 2.ConclusionsDesign modifications applied to the newer TKA system allowed greater flexion and lower patellofemoral complications but did not appear to achieve better overall clinical scores.

Patient reported outcomes and implant survivorship after Total knee arthroplasty with the persona knee implant system: two year follow up

“…Patient reported outcome measures were promising in this study; all measures improved significantly up to one year after surgery. The OKS, one year after surgery in this study (41.1 points) is considerably higher when compared to other TKA cohorts [17–19]. Moreover, the results of the OKS in the current study are comparable to the results of the OKS of a partial knee arthroplasty [20, 21].…”

Intraoperative load-sensing drives the level of constraint in primary total knee arthroplasty: Surgical technique and review of the literature

“…Recent reports, including those from the author's institution, have shown that the use of modern, third-generation TKA designs and instrumentation did not improve satisfaction rates in the TKA patient population. 5,6 Given this, studies show that using the minimum level of constraint to maintain stability has been related to a higher survivorship and patient satisfaction. 7 Many surgeons, however, fearing mid-flexion instability as a cause for early revision, 8 tend to over-constrain the knee resulting in loss of active ROM, point loading on the polyethylene insert, premature insert wear, and inferior implant survivorship.…”

A New Total Knee Arthroplasty Design Has Significantly Better Early Implant Survivorship than a Previous Gold-Standard Design—A Retrospective Analysis of 1,000 Cases

“…32 Other authors have also shown increased range of motion with the ATTUNE system. 34 A comparison of ATTUNE and PFC TKA in Asian population showed improved Western Ontario and McMaster (WOMAC) scores and knee flexion in the ATTUNE group. 36 It is worth noting that these studies all have much smaller numbers in each group than our study.…”

“…30 This implant has also demonstrated a shorter length of stay and decreased likelihood of requiring a skilled nursing facility on discharge, thus reducing overall hospital costs. 31 Previous studies have shown improved patellofemoral symptoms and crepitus with the ATTUNE compared with the PFC Sigma, [32][33][34][35] although little difference in clinical outcome or satisfaction. 32 Other authors have also shown increased range of motion with the ATTUNE system.…”