High-Flexion Total Knee Arthroplasty Using NexGen LPS-Flex System: Minimum 5-year Follow-up Results
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: This study is to report clinical and radiological results of high-flexion total knee arthroplasty (TKA) using NexGen LPS-flex system at a minimum 5-year follow-up, and to analyze the implant survivorship based on the results.Materials and Methods: A total of 80 patients (118 knees) who underwent patellar preserving TKA using NexGen LPS-flex implant between February 2007 and February 2008 and could be followed for minimum 5 years were reviewed. The range of motion (ROM), hip-knee-ankle angle, Knee Society Knee score (KSKS), and Knee Society Function score (KSFS) were assessed preoperatively and at the last follow-up and analyzed. Implant position of the femoral and tibial components on the immediate postoperative and last follow-up X-rays were compared.Results: The mean ROM was 110.2o±14.5o (range, 60o to 140o) preoperatively and 132.4o±5.2o (range, 90o to 145o) at the last follow-up. KSKS was 36.9o±6.4o preoperatively and 94.2o±3.2o at the last follow-up. KSFS was 30.5o±5.7o preoperatively and 93.7o±4.1o at the last follow-up. There was no statistically significant change in the implant position measured as α, β, γ, and δ angles at the last follow-up compared to the immediate postoperative values. Radiolucent lines were observed in 13 knees (11%) on the last follow-up X-rays. Revision TKA was performed due to aseptic implant loosening in 1 knee (0.84%), and the survival rate at the 5th postoperative year was 99.2%.Conclusions: The clinical and radiological outcomes of high-flexion TKA using NexGen LPS-Flex implant design were satisfactory with 99.2% implant survival rate after 5 years of protected activities of daily living.
Abstract
Purpose: This study is to report clinical and radiological results of high-flexion total knee arthroplasty (TKA) using NexGen LPS-flex system at a minimum 5-year follow-up, and to analyze the implant survivorship based on the results.Materials and Methods: A total of 80 patients (118 knees) who underwent patellar preserving TKA using NexGen LPS-flex implant between February 2007 and February 2008 and could be followed for minimum 5 years were reviewed. The range of motion (ROM), hip-knee-ankle angle, Knee Society Knee score (KSKS), and Knee Society Function score (KSFS) were assessed preoperatively and at the last follow-up and analyzed. Implant position of the femoral and tibial components on the immediate postoperative and last follow-up X-rays were compared.Results: The mean ROM was 110.2o±14.5o (range, 60o to 140o) preoperatively and 132.4o±5.2o (range, 90o to 145o) at the last follow-up. KSKS was 36.9o±6.4o preoperatively and 94.2o±3.2o at the last follow-up. KSFS was 30.5o±5.7o preoperatively and 93.7o±4.1o at the last follow-up. There was no statistically significant change in the implant position measured as α, β, γ, and δ angles at the last follow-up compared to the immediate postoperative values. Radiolucent lines were observed in 13 knees (11%) on the last follow-up X-rays. Revision TKA was performed due to aseptic implant loosening in 1 knee (0.84%), and the survival rate at the 5th postoperative year was 99.2%.Conclusions: The clinical and radiological outcomes of high-flexion TKA using NexGen LPS-Flex implant design were satisfactory with 99.2% implant survival rate after 5 years of protected activities of daily living.
참고문헌 (30)
- Anouchi YS, "Range of motion in total knee replacement", Clin Orthop Relat Res, (331), pp.87~92 (1996)
- Endres S., "High-flexion versus conventional total knee arthroplasty: a 5-year study", J Orthop Surg (Hong Kong), 19, pp.226~229 (2011)
- Huddleston JI, "2009 Marshall Urist Young Investigator Award: how often do patients with high-flex total knee arthroplasty use high flexion?", Clin Orthop Relat Res, 467, pp.1898~1906 (2009)
- Miner AL, "Kinemax Outcomes Group. Knee range of motion after total knee arthroplasty: how important is this as an outcome measure?", J Arthroplasty, 18, pp.286~294 (2003)
- Cho SD, "Three- to six-year follow-up results after high-flexion total knee arthroplasty: can we allow passive deep knee bending?", Knee Surg Sports Traumatol Arthrosc, 19, pp.899~903 (2011)
- Moon YW, "Minimum five-year follow-up results of single-radius, high-flex posterior-stabilized TKA", Orthopedics, pp.33~ (2010)
- Bauman RD, "Can a high-flexion total knee arthroplasty relieve pain and restore function without premature failure?", Clin Orthop Relat Res, 470, pp.150~158 (2012)
- Lee BS, "High-flexion total knee arthroplasty improves flexion of stiff knees", Knee Surg Sports Traumatol Arthrosc, 19, pp.936~942 (2011)
- Kim YH, "Range of motion of standard and high-flexion posterior stabilized total knee prostheses: a prospective, randomized study", J Bone Joint Surg Am, 87, pp.1470~1475 (2005)
- Malik A, "Range of motion and function are similar in patients undergoing TKA with posterior stabilised and high-flexion inserts", Int Orthop, 34, pp.965~972 (2010)
- McCalden RW, "A randomized controlled trial comparing “high-flex” vs “standard” posterior cruciate substituting polyethylene tibial inserts in total knee arthroplasty", J Arthroplasty, 24(6 Suppl), pp.33~38 (2009)
- Ng FY, "Comparison of range of motion after standard and high-flexion posterior stabilised total knee replacement", Int Orthop, 32, pp.795~798 (2008)
- Nutton RW, "A prospective randomised double-blind study of functional outcome and range of flexion following total knee replacement with the NexGen standard and high flexion components", J Bone Joint Surg Br, 90, pp.37~42 (2008)
- Argenson JN, "A high flexion total knee arthroplasty design replicates healthy knee motion", Clin Orthop Relat Res, (428), pp.174~179 (2004)
- Bin SI, "Early results of high-flex total knee arthroplasty : comparison study at 1 year after surgery", Knee Surg Sports Traumatol Arthrosc, 15, pp.350~355 (2007)
- Li G, "Knee kinematics with a high-flexion posterior stabilized total knee prosthesis : an in vitro robotic experimental investigation", J Bone Joint Surg Am, 86, pp.1721~1729 (2004)
- Weeden SH, "A randomized, prospective study of primary total knee components designed for increased flexion", J Arthroplasty, 22, pp.349~352 (2007)
- Long WJ, "High-flexion total knee arthroplasty", J Arthroplasty, 23(7 Suppl), pp.6~10 (2008)
- Ritter MA, "Predicting range of motion after total knee arthroplasty. Clustering, log-linear regression, and regression tree analysis", J Bone Joint Surg Am, 85, pp.1278~1285 (2003)
- Argenson JN, "In vivo kinematic evaluation and design considerations related to high flexion in total knee arthroplasty", J Biomech, 38, pp.277~284 (2005)
- Goldstein WM, "Why posterior cruciate-retaining and substituting total knee replacements have similar ranges of motion. The importance of posterior condylar offset and cleanout of posterior condylar space", J Bone Joint Surg Am, 88(Suppl 4), pp.182~188 (2006)
- Massin P, "Optimization of the posterior condylar offset, tibial slope, and condylar roll-back in total knee arthroplasty", J Arthroplasty, 21, pp.889~896 (2006)
- Figgie HE 3rd, "The influence of tibial-patellofemoral location on function of the knee in patients with the posterior stabilized condylar knee prosthesis", J Bone Joint Surg Am, 68, pp.1035~1040 (1986)
- Han HS, "High incidence of loosening of the femoral component in legacy posterior stabilised-flex total knee replacement", J Bone Joint Surg Br, 89, pp.1457~1461 (2007)
- 한창욱, "Evaluation of Postoperative Range of Motion and Functional Outcomes after Cruciate-Retaining and Posterior-Stabilized High-Flexion Total Knee Arthroplasty", Yonsei Medical Journal, 53(4), pp.794~800 (2012), 연세대학교의과대학[DOI]
- Kim YH, "High-flexion total knee arthroplasty : survivorship and prevalence of osteolysis : results after a minimum of ten years of follow-up", J Bone Joint Surg Am, 94, pp.1378~1384 (2012)
- Lionberger DR, "Improved knee flexion following high-flexion total knee arthroplasty", J Orthop Surg Res, 7, pp.22~ (2012)
- Singh H, "Gender-specific high-flexion knee prosthesis in Indian women : a prospective randomised study", J Orthop Surg(Hong Kong), 20, pp.153~156 (2012)
- Wohlrab D, "Clinical and radiological results of high flex total knee arthroplasty : a 5 year follow-up", Arch Orthop Trauma Surg, 129, pp.21~24 (2009)
- Yagishita K, "High-flex posterior cruciate-retaining vs posterior cruciate-substituting designs in simultaneous bilateral total knee arthroplasty : a prospective, randomized study", J Arthroplasty, 27, pp.36~ (2012)