Posteriorly stabilised (Insall-Burstein) total condylar knee arthroplasty

Abstract

We reviewed 157knees in ll8patients who underwent posteriorly stabilised (Insall-Burstein) knee replacement arthroplasty. Their mean age at operation was 69years (range 47 to 85years) and the average follow-up was 3.5years (range 2 to 7years). The "BASK" knee function assessment chart was utilised to evaluate the functional and clinical results. One hundred and thirtyfive knees (86%) had excellent or good results, 16 knees (10%) had fair results and six (4%) had poor results. The mean postoperative B A S K score was 79 points and the average postoperative knee flexion was 95 ° (range 65 ° to 130°). Two patients had a superficial infection, one deep sepsis requiring revision arthroplasty and two mechanical loosening. Patellar impingement symptoms were present in 8% of the knees, although they were troublesome in less than half. Varus alignment of the knee and a varus tilt of the tibial component of more than 2 ° correlated with the incidence o f radiolucent lines around the tibial prosthesis. 90% of the patients were pleased or satisfied with the functional result. The total condylar knee is a safe, reliable and versatile prosthesis. R~sum& Nous avons revu 157 genoux chez 118 malades ayant bOnOficiO d'une arthroplastie par prothose semi-contrainte (Insall-Burstein). L ~ge moyen lots de l'op&ation btait de 69 ans (de 47 d 85) et le recul moyen Otait de 3 ans et demi (de 2 fi 7). Pour Ovaluer les rOsultats fonctionnels et cliniques, nous avons eu recours d l'Ochelle de cotation fonctionnelle ¢¢BASK)). Le r&ultat Otait excellent Reprint request to: P. M. Aichroth ou bon dans 135 genoux (86%), moyen dans 16 (10%) et mauvais dans 6 (4%). La cotation post-opdratoire ,¢BASK~ dtait en moyenne de 79 points et la flexion post-op&atoire moyenne de 95 ° (de 65 ° ~i 130°). Deux opdr& avaient pr&entb une infection superficielle, un seul un sepsis profond ayant nOces-sitO une reprise de l'arthroplastie et deux un descellement m&anique. Des signes d'hyperpression rotulienne pouvaient ~tre not& dans 8% des genoux mais ils n'avaient de traduction clinique que dans moins de la moitiO des cas. L'existence d'un liserO autour de la pi&e tibiale 6tait correlOe avec une dbsaxation du genou en varus ou avec un positionnement en varus du composant tibial sup&ieur d 2 °. La proth&e total-condylar est donc s~tre, efficace et susceptible de s'adapter aux diverses bventualit&.

Fat-pad impingement after total knee arthroplasty with the LCS A/P-Glide system

“…After total knee replacements, other impingement problems have been widely described by several authors, such as: (a) impingement due to hypertrophic fibrous tissue or nodules in the intercondylar notch [4,12], (b) impinging hypertrophic synovitis [5], (c) intraarticular fibrous plicae and bands [14,24], (d) soft tissue under the patella consistent with the "clunk" syndrome [5,15], (e) impinging PCL stump [5], (f) impingement caused by cement extrusion and proximal tibiofibular instability [19], and (g) fabellar impingement [8,25]. Patellotibial impingement has been described by Grigoris [10] in Kinemax-stabilised total knee replacement and by Patel [20], who reported mild patellar impingement symptoms in 8% of 157 patients with a posteriorly-stabilised (Insall-Burstein) knee replacement.…”

Short-Term Recovery From Hip and Knee Arthroplasty

“…For hip arthroplasty, this is usually within three months (Lichtenstein, Semaan and Marmar 1993;Borstlap et al 1994); recovery from knee arthroplasty takes longer (Wright et al 1990;Patel, Aichroth and Wand 1991). Our aim was to assess the outcome in terms of functional recovery, fatigue and psychological variables during the two months after operation.…”

Analysis of Impingement between Patella Bone and Bearing Post in Cruciate-Substituting High-Flexion Total Knee Arthroplasty

“… 1 2 3 4 5) However, patella impingement, patellotibial impingement, and fat pad impingement following total knee arthroplasty are the known causes of anterior knee pain; and the methods for preventing anterior knee pain include change in bearing design and intraoperative removal of the fat pad. 6 7 8 9 10) In some patients with an expected knee joint movement of more than 130° in the operative field, the range of motion is less than 110° due to anterior knee pain caused by impingement between the patella bone and the bearing post after mobile and fixed type total knee arthroplasty; these patients were treated by resection of the lower articular part of the patella bone and the impinged soft tissue. Therefore, impingement between the patella bone and the bearing post after total knee arthroplasty was one of the causes of less than 120° knee flexion.…”