The GSB total knee arthroplasty

Abstract

From 1981 to 1987, 77 GSB-II total knee arthroplasties were implanted in 65 patients. There were 23 men and 42 women aged on average 60 years old (range 30-85 years). The diagnosis was osteoarthritis (OA) in 21 knees, rheumatoid arthritis (RA) in 44 knees, and other in 12 knees. A clinical and radiological follow-up was performed in two stages after a mean of 6.7 years (61 knees) and 14.8 years (22 knees) to assess the medium- and long-term results and to determine if deterioration had occurred after mid-term follow-up. A survival analysis was done with two endpoints: (1) revision, and (2) revision, moderate or severe pain and lost to follow-up (worst-case scenario). At the last follow-up 36 patients (44 knees) had died, 2 patients (2 knees) refused examination, and 3 patients (3 knees) were lost to follow-up. Six knees had been revised for malposition (1.3%), septic (3.9%) and aseptic (2.6%) loosening. The mean Knee Society score after 6.7 and 14.8 years was 85 points (OA 82 points, RA 87 points). Lateralisation, subluxation or dislocation of the patella was present in 8 of 17 knees at the last follow-up. The 6- and 15-year survival rates with revision as the endpoint were 95% (CI 89%-100%) and 87% (CI 65%-100%), respectively. For the worst-case scenario, the 6- and 15-year survival rates were 95% (CI 89%-100%) and 56% (CI 0%-100%), respectively. The medium- and long-term results of the GSB-II total knee arthroplasty were good, and a decline in the knee score did not occur beyond the mid-term follow-up. Patella complications were abundant, and a marked decrease in implant survival was noted when moderate or severe pain and lost to follow-up were included as endpoints.

Mid-term survival following primary hinged total knee replacement is good irrespective of the indication for surgery

“…A large proportion of operations were performed for inflammatory arthritis and trauma [n = 176 (18 %)], when compared to cemented total knee replacement (\3 %) [2]. This is again reflected in smaller series from the literature, documenting surgical outcomes after hinged replacements for degenerative/ inflammatory arthritis [9,22,24,[27][28][29], acute fractures [4], bone tumours [11,19], severe ligamentous instability [16] and a combination of reasons [20].…”

“…As such information about the behaviour of these implants, particularly when used for primary replacement, is limited. The small number of published case series pertaining to primary hinged knee replacement suggests that these implants produce functional improvements and rates of survival comparable to conventional cemented knee replacements [4,9,11,16,19,20,22,24,[27][28][29]. However, these conclusions are based upon a small number of largely retrospective case series which have reported on primary hinged implants undertaken for a variety of reasons using a wide range of surgical outcome measures [4,9,11,16,19,20,22,24,[27][28][29].…”

“…The small number of published case series pertaining to primary hinged knee replacement suggests that these implants produce functional improvements and rates of survival comparable to conventional cemented knee replacements [4,9,11,16,19,20,22,24,[27][28][29]. However, these conclusions are based upon a small number of largely retrospective case series which have reported on primary hinged implants undertaken for a variety of reasons using a wide range of surgical outcome measures [4,9,11,16,19,20,22,24,[27][28][29]. Furthermore, it could be argued that the heterogeneity of these papers makes it difficult to draw distinct conclusions and have confidence in the expected results when using this type of implant.…”

Asian-Specific total knee system: 5-14 year follow-up study

“…Therefore, this model can also correspond to severe deformities and instability without an intramedullary stem. Further, this type of constrained implant has demonstrated a lower rate of patellar complications than other types of prostheses, despite its being characterized by nearly complete constraints [19]. …”

Management of Tibial Bony Defect with Metal Block in Primary Total Knee Replacement Arthroplasty

“…Tibial bony defect has been managed with bone cementing, insertion of a thick polyethylene implant after bone resection down to bone defect, or bone grafting3-9). Some recent studies have introduced metal wedge or block augmentation methods10-12).…”