Uncemented Rotating-Platform Total Knee Arthroplasty

Ali, M. Salman; Mangaleshkar, S.R.

doi:10.1016/j.arth.2005.04.018

Cited by 36 publications

(15 citation statements)

References 23 publications

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“…However, little data exists concerning the issue of cement or cementless keel/stem fixation in association with cemented tibial tray fixation. Many factors affect the stability of the tibial component, and different designs may have substantially differing degrees of stability, regardless of cement fixation [1,6,7,11,14,22,25]. Several clinical studies have addressed these issues with conflicting results.…”

Section: Discussionmentioning

confidence: 98%

Total knee arthroplasty using cementless keels and cemented tibial trays: 10-year results

Kolisek

Mont

Seyler

et al. 2008

International Orthopaedics (SICO

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The problem of early mechanical stability of cemented and cementless keels of the tibial component in total knee arthroplasty (TKA) is controversial. The purpose of this study was to assess clinical and radiographic outcomes of a cohort of 51 TKAs using a cemented platform with cementless keel fixation. At a mean followup of 10.4 years (range, 7 to 14 years), the mean Knee Society Score (KSS) was 93 points (range, 59 to 100 points), and the mean functional score was 73 points (range, 0 to 100 points). Only one patient demonstrated progressive tibial radiolucencies at 13.1 years follow-up, which resolved with a revision with an exchange of components. The results of this study suggest that a proximally cemented tibial tray with a press-fit keel TKA provides excellent mean 10-year outcomes.

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Section: Discussionmentioning

confidence: 98%

Total knee arthroplasty using cementless keels and cemented tibial trays: 10-year results

Kolisek

Mont

Seyler

et al. 2008

International Orthopaedics (SICO

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“…22 In the last decade, more favourable medium-term survival has been reported for uncemented TKR with results comparable with those of cemented TKR. 13,14,23,24 Longterm survivorship data for uncemented TKR is less evident. Goldberg and Kraay 25 reported a 14-to 17-year follow-up of an uncemented TKR with screw fixation of the tibial base plate and a titanium alloy femoral component, which had an overall survival of 87% (95% CI 79 to 93) but some of the osteolysis was attributed to the presence of the titanium bearing surface.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome in an uncemented, hydroxyapatite-coated total knee replacement

Melton

Mayahi

Baxter

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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A consecutive series of patients with a hydroxyapatite-coated uncemented total knee replacement (TKR) performed by a single surgeon between 1992 and 1995 was analysed. All patients were invited for clinical review and radiological assessment. Revision for aseptic loosening was the primary outcome. Assessment was based on the Knee Society clinical score (KSS) and an independent radiological analysis. Of 471 TKRs performed in 356 patients, 432 TKRs in 325 patients were followed for a mean of 16.4 years (15 to 18). The 39 TKRs in 31 patients lost to follow-up had a mean KSS of 176 (148 to 198) at a mean of ten years. There were revisions in 26 TKRs (5.5%), of which 11 (2.3%) were for aseptic loosening. Other further surgery was carried out on 49 TKRs (10.4%) including patellar resurfacing in 20, arthrolysis in 19, manipulation under anaesthetic in nine and extensor mechanism reconstruction in one. Survivorship at up to 18 years without aseptic loosening was 96% (95% confidence interval 91.9 to 98.1), at which point the mean KSS was 176 (134 to 200). Of 110 knees that underwent radiological evaluation, osteolysis was observed in five (4.5%), one of which was revised. These data indicate that uncemented hydroxyapatite-coated TKR can achieve favourable long-term survivorship, at least as good as that of cemented designs.

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“…Total knee replacement (TKR) has provided success rates of > 90%, 1-13 with many studies reporting success rates > 95% after ten or more years. 1,3,4,6,7,10-12 In order to further improve the procedure, debate has arisen regarding sources of failure in TKR, including examination of the role of the posterior cruciate ligament (PCL).…”

Section: Introductionmentioning

confidence: 99%

“…1,3,4,6,7,10-12 In order to further improve the procedure, debate has arisen regarding sources of failure in TKR, including examination of the role of the posterior cruciate ligament (PCL). Some studies have demonstrated less consistent success with retention of the PCL, 9,14 while other studies have found advantages in proprioception 15 and kinematics 16-20 when the PCL is retained.…”

Section: Introductionmentioning

confidence: 99%

The role of the posterior cruciate ligament in total knee replacement

Ritter¹,

Davis²,

Meding³

et al. 2012

Bone & Joint Research

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ObjectivesThe purpose of this study was to examine the effect of posterior cruciate ligament (PCL) retention, PCL recession, and PCL excision during cruciate-retaining total knee replacement.MethodsA total of 3018 anatomic graduated component total knee replacements were examined; 1846 of these retained the PCL, 455 PCLs were partially recessed, and in 717 the PCL was completely excised from the back of the tibia.ResultsClinical scores between PCL groups favored excision for flexion (p < 0.0001), and recession and retention for stairs (p < 0.0001). There was a mild difference in long-term all-cause aseptic survivorship between PCL-retained (96.4% at 15 years) combined with PCL-recessed groups (96.6% at 15 years) when compared with the PCL-excised group (95.0% at 15 years) (p = 0.0411, Wilcoxon; p = 0.0042, log-rank), as well as tibial or femoral loosening, which reported prosthesis survival of 97.8% at 15 years for PCL-retained knees, 98.2% for recessed knees, and 96.4% for excised knees (p = 0.0934, Wilcoxon; p = 0.0202, log-rank).ConclusionsDespite some trade off in clinical performance, if the PCL is detached at the time of operation, conversion to a posterior-stabilised prosthesis may not be necessarily required as long as stability in the anteroposterior and coronal planes is achieved.

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Uncemented Rotating-Platform Total Knee Arthroplasty

Cited by 36 publications

References 23 publications

Total knee arthroplasty using cementless keels and cemented tibial trays: 10-year results

Total knee arthroplasty using cementless keels and cemented tibial trays: 10-year results

Long-term outcome in an uncemented, hydroxyapatite-coated total knee replacement

The role of the posterior cruciate ligament in total knee replacement

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