Time-Dependent Clinical Results of Rotating-Platform Total Knee Arthroplasty According to Mechanical Axis Deviation
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: We hypothesized that the low contact stress (LCS) posterior stabilization system in knees with ≤3o deviation of coronal alignment would provide more favorable clinical outcomes and survival rate over the course of time. Materials and Methods: A retrospective study was performed on 253 consecutive cases of primary total knee arthroplasty (TKA). Patients were classified according to the degree of deviation of coronal alignment on the initial postoperative radiograph as Group 1 (≤3o deviation) and Group 2 (>3o deviation). The clinical assessments were performed using the Knee Society score and Hospital for Special Surgery systems and Western Ontario and McMaster Universities index.Results: The survival rate was 97.4% in Group 1 and 96.8% in Group 2. No statistically significant intergroup difference was observed in the clinical scores before surgery and since 1 year after surgery (p>0.05). However, a significant intergroup difference was noted between 6 months to 1 year after surgery (p<0.001). Less than 2 mm radiolucent lines were found more frequently in Group 2. Time-dependent improvement was noted within one year after TKA in both groups. Conclusions: Most of the expected improvements were achieved at 6 months after surgery in Group 1 and at 1 year after surgery in Group 2. The present study suggests that the LCS system yields time-dependent improvement regardless of coronal alignment deviation.
Abstract
Purpose: We hypothesized that the low contact stress (LCS) posterior stabilization system in knees with ≤3o deviation of coronal alignment would provide more favorable clinical outcomes and survival rate over the course of time. Materials and Methods: A retrospective study was performed on 253 consecutive cases of primary total knee arthroplasty (TKA). Patients were classified according to the degree of deviation of coronal alignment on the initial postoperative radiograph as Group 1 (≤3o deviation) and Group 2 (>3o deviation). The clinical assessments were performed using the Knee Society score and Hospital for Special Surgery systems and Western Ontario and McMaster Universities index.Results: The survival rate was 97.4% in Group 1 and 96.8% in Group 2. No statistically significant intergroup difference was observed in the clinical scores before surgery and since 1 year after surgery (p>0.05). However, a significant intergroup difference was noted between 6 months to 1 year after surgery (p<0.001). Less than 2 mm radiolucent lines were found more frequently in Group 2. Time-dependent improvement was noted within one year after TKA in both groups. Conclusions: Most of the expected improvements were achieved at 6 months after surgery in Group 1 and at 1 year after surgery in Group 2. The present study suggests that the LCS system yields time-dependent improvement regardless of coronal alignment deviation.
참고문헌 (30)
- Epinette JA, "Hydroxyapatite-coated total knee replacement : clinical experience at 10 to 15 years", J Bone Joint Surg Br, 89, pp.34~38 (2007)
- Baker PN, "A randomised controlled trial of cemented versus cementless press-fit condylar total knee replacement : 15-year survival analysis", J Bone Joint Surg Br, 89, pp.1608~1614 (2007)
- Buechel FF Sr, "Twenty-year evaluation of meniscal bearing and rotating platform knee replacements", Clin Orthop Relat Res, 388, pp.41~50 (2001)
- Callaghan JJ, "Cemented rotating-platform total knee replacement : a nine to twelve-year follow-up study", J Bone Joint Surg Am, 82, pp.705~711 (2000)
- Huang CH, "Long-term results of low contact stress mobile-bearing total knee replacements", Clin Orthop Relat Res, 416, pp.265~270 (2003)
- Insall J, "The total condylar knee prosthesis : a report of two hundred and twenty cases", J Bone Joint Surg Am, 61, pp.173~180 (1979)
- Werner FW, "The effect of valgus", varus malalignment on load distribution in total knee replacements, 2005, pp.38, 349~355
- Sikorski JM, "Alignment in total knee replacement", J Bone Joint Surg Br, 90, pp.1121~1127 (2008)
- Bathis H, "Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique", J Bone Joint Surg Br, 86, pp.682~687 (2004)
- KAT Trial Group, "The Knee Arthroplasty Trial(KAT)design features, baseline characteristics, and two-year functional outcomes after alternative approaches to knee replacement", J Bone Joint Surg Am, 91, pp.134~141 (2009)
- Kennedy DM, "Preoperative function and gender predict pattern of functional recovery after hip and knee arthroplasty", J Arthroplasty, 21, pp.559~566 (2006)
- Kennedy DM, "Assessing recovery and establishing prognosis following total knee arthroplasty", Phys Ther, 88, pp.22~32 (2008)
- Bellemans J, "The Chitranjan Ranawat award : is neutral mechanical alignment normal for all patients? The concept of constitutional varus", Clin Orthop Relat Res, 470, pp.45~53 (2012)
- Parratte S, "Effect of postoperative mechanical axis alignment on the fifteen-year survival of modern, cemented total knee replacements", J Bone Joint Surg Am, 92, pp.2143~2149 (2010)
- Jung YB, "Comparison of the modified subvastus and medial parapatellar approaches in total knee arthroplasty", Int Orthop, 33, pp.419~423 (2009)
- Kaplan EL, "Nonparametric estimation from incomplete observations", J Am Stat Assoc, 53, pp.457~481 (1958)
- Pappas MJ, "Engineering design of the LCS knee replacement", pp.39~52 (2002), Springer
- Kim YH, "Comparison of anterior-posterior-glide and rotating-platform low contact stress mobile-bearing total knee arthroplasties", J Bone Joint Surg Am, 86, pp.1239~1247 (2004)
- Ho FY, "Mobile-bearing knees reduce rotational asymmetric wear", Clin Orthop Relat Res, 462, pp.143~149 (2007)
- Huang NF, "Coronal alignment correlates with outcome after total knee arthroplasty : five-year follow-up of a randomized controlled trial", J Arthroplasty, 27, pp.1737~1741 (2012)
- Astephen Wilson JL, "Preoperative gait patterns and BMI are associated with tibial component migration", Acta Orthop, 81, pp.478~486 (2010)
- Bonner TJ, "The effect of post-operative mechanical axis alignment on the survival of primary total knee replacements after a follow-up of 15 years", J Bone Joint Surg Br, 93, pp.1217~1222 (2011)
- Petersen TL, "Radiographic assessment of knee alignment after total knee arthroplasty", J Arthroplasty, 3, pp.67~72 (1988)
- Vogt JC, "LCS mobile-bearing total knee replacement. A 10-year’s follow-up study", Orthop Traumatol Surg Res, 95, pp.177~182 (2009)
- Nilsdotter AK, "A 5 year prospective study of patient-relevant outcomes after total knee replacement", Osteoarthritis Cartilage, 17, pp.601~606 (2009)
- Jordan LR, "Survivorship analysis of cementless meniscal bearing total knee arthroplasty", Clin Orthop Relat Res, 338, pp.119~123 (1997)
- Sanchez-Sotelo J, "Results and complications of the low contact stress knee prosthesis", J Arthroplasty, 14, pp.815~821 (1999)
- Hooper G, "The low contact stress mobile-bearing total knee replacement : a prospective study with a minimum follow-up of ten years", J Bone Joint Surg Br, 91, pp.58~63 (2009)
- Sadoghi P, "Radiolucent lines in low-contact-stress mobile-bearing total knee arthroplasty : a blinded and matched case control study", BMC Musculoskelet Disord, 12, pp.142~ (2011)
- Hilding MB, "Knee joint loading and tibial component loosening. RSA and gait analysis in 45 osteoarthritic patients before and after TKA", J Bone Joint Surg Br, 78, pp.66~73 (1996)