The benefit of revision knee arthroplasty for component malrotation after primary total knee replacement

Sternheim, Amir; Lochab, Jasjit; Drexler, Michael; Kuzyk, Paul; Safir, Oleg; Gross, Allan E.; Backstein, David

doi:10.1007/s00264-012-1675-6

Cited by 45 publications

(32 citation statements)

References 15 publications

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“…According to the literature, our outcomes are very similar to those published [9,18,20,22,23]. While our mean clinical KSS was 63.85 ± 20.71, our mean functional KSS was 68.24±24.95.…”

Section: Discussionsupporting

confidence: 77%

“…A total of 19 % of our patients had morbid obesity (BMI>40), which is a percentage similar to published series [23][24][25][26][27][28][29][30][31]. Also, 18 % of our patients had diabetes mellitus, and 9.3 % were rheumatic patients.…”

Section: Discussionsupporting

confidence: 71%

“…While our mean clinical KSS was 63.85 ± 20.71, our mean functional KSS was 68.24±24.95. Some published replacement series with PS implants obtained worst outcomes: a KSS-C of 68 and a KSS-F of 56 [22] or KSSC of 57 and KSSF 76 [23]. Other authors published better results: a KSSC of 77 and a KSSF of 49 [20] or KSSC of 88.5 and KSSF of 72.4 [9].…”

Section: Discussionmentioning

confidence: 91%

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Predictive factors for failure after total knee replacement revision

Luque

Rizo

Urda

et al. 2014

International Orthopaedics (SICOT)

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Purpose We used the Optetrak Condylar Constrained (CCK) implant, a modular and constrained knee implant as replacement for a failed primary arthroplasty, to assess the survivorship, the complications, the clinical, radiological, and functional situation, and the quality of life of those patients in whom a CCK had been implanted in recent years in order to find predictive pre-operative conditions of survival and clinical outcomes. Methods We performed a retrospective study of 125 CCK implanted between 1999 and 2005. The mean follow-up was nine years (range, seven to 13). Mean age was 73.6 years. A total of 78 % of the revised TKA were cemented and 66 % were CR. We assessed the pre-operative, the operative and the postoperative conditions studying the medical files of all the patients. In order to study the functional and clinical situation we used the Hospital for Special Surgery (HSS) score and the Knee Society score (KSS), both clinical and functional. We analysed all the X-rays using the Knee Society Roentgenographic evaluation. The quality of life was studied using the Oxford knee score (OKS). Results The mean results of the KSS clinical and the KSS functional were 68.24 and 63.85, respectively. There were not any conditions associated with poor results of the knees (p>0.05). The global survival at 24 months was 92.7 %, at 60 months 87.8 % and at 96 months it was 87.8 %. There were some conditions associated with poor survival of the knees, e.g. patients were younger than 70 years old, rheumatic diseases, kidney faliure, tibial tuberosity osteotomy, PS primary arthroplasty, revision before five years and septic loosening.Conclusions Based on these results there are some preoperative factors that change the survival of the total knee replacement revision.

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“…According to the literature, our outcomes are very similar to those published [9,18,20,22,23]. While our mean clinical KSS was 63.85 ± 20.71, our mean functional KSS was 68.24±24.95.…”

Section: Discussionsupporting

confidence: 77%

Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 91%

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Predictive factors for failure after total knee replacement revision

Luque

Rizo

Urda

et al. 2014

International Orthopaedics (SICOT)

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“…Apart from infections, the principal causes of revision TKA failure are wear, aseptic loosening [9] and instability due to the inappropriate choice of revision implant constraint [6,10]. In fact, one of the greatest challenges during revision TKA is the management of the ligamentous instability affecting both the function and final survival of the knee joint reconstruction [5,11].…”

Section: Introductionmentioning

confidence: 99%

Constraint choice in revision knee arthroplasty

Vasso

Beaufils

Panni

2013

International Orthopaedics (SICOT)

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Purpose Along with the increase in primary total knee arthroplasty, there has been an increase in the number of revisions. The aim of this study was to propose a selection algorithm for the knee revision constraint according to the state of ligaments and to the bone defects Anderson Orthopaedic Research Institute Classification [AORI] classification. The hypothesis was that this algorithm would facilitate the appropriate choice of prosthesis constraint, thus providing stable components and a good long-term survivorship of the knee revisions. Methods Sixty consecutive revision knee arthroplasties in 57 patients were prospectively evaluated. Prostheses implanted at revision included postero-stabilised, condylar constrained and rotating hinged, relative to the state of the ligaments and of the bone loss around the knee. The median follow-up was nine years (range, 4-12). Results The median IKS knee and function scores and HSS score were 41 (15-62), 21.5 (12-43) and 34 (23-65) points, respectively, before the operation, and 81 (48-97), 79 (56-92) and 83.5 (62-98) points (p<0.001) at the latest followup evaluation. The median ROM increased from 74°(29-110°) preoperatively to 121°(98-132°) (p<0.01) at the final follow-up. Re-revision was necessary in five (8.3 %) patients. Conclusions A selection algorithm for the revision implant constraint based on the state of ligaments and the bone loss AORI classification could provide stable knee reconstructions and long-term success of knee revisions.

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“…It was reported that revision surgery for malrotation is beneicial with regard to clinical and functional outcome [25]. Biomechanical data from cadaver testing on implications of malrotation of TKA components focused on tibiofemoral kinematics are scarce.…”

Section: Introductionmentioning

confidence: 99%

Internal femoral component malrotation in TKA significantly alters tibiofemoral kinematics

Heyse

El-Zayat

Corte³

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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tibia in lexion (squat 33-111°, p < 0.05), an elevated (squat 43-111°, p < 0.05) and more anterior (passive 61-126°, p < 0.05) located medial femoral condyle and a lateral femoral condyle located more posterior and inferior (squat 73-111°, p < 0.05) than in the neutrally aligned TKA. External component malrotation caused only little changes under passive motion. Under a squat there was less internal rotation and more adduction to the tibia (33-111°, p < 0.05). The medial femoral condyle was moved more posterior (squat 59-97°, p < 0.05), the lateral femoral condyle more superior (squat 54-105°, p < 0.05) than in the neutrally aligned TKA. Conclusion The greatest diferences to the native tibiofemoral kinematics were introduced by internal rotation of the femoral component. Also neutrally and externally rotated femoral components introduce kinematic changes, but to a lesser extent. With respect to the alterations introduced to kinematics internal malrotation should be avoided when performing PS TKA.

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The benefit of revision knee arthroplasty for component malrotation after primary total knee replacement

Cited by 45 publications

References 15 publications

Predictive factors for failure after total knee replacement revision

Predictive factors for failure after total knee replacement revision

Constraint choice in revision knee arthroplasty

Internal femoral component malrotation in TKA significantly alters tibiofemoral kinematics

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