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International Orthopaedics

Erschienen in:

22.03.2017 | Original Paper

Long-term follow-up of a non-randomised prospective cohort of one hundred and ninety two total knee arthroplasties using the NexGen implant

verfasst von: Alfredo Schiavone Panni, Franceso Falez, Rocco D’Apolito, Katia Corona, Carlo Perisano, Michele Vasso

Erschienen in: International Orthopaedics | Ausgabe 6/2017

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Abstract

Purpose

The purpose of this study was to retrospectively analyse the clinical, functional and radiological outcomes, and the long-term survivorship of the NexGen Legacy Posterior Stabilised (LPS) knee prosthesis (Zimmer Biomet, Warsaw, IN, USA).

Methods

Between 1996 and 2001, 197 primary NexGen LPS total knee arthroplasties (TKAs) were implanted by a single surgeon; 132 prostheses in 124 patients with a minimum follow-up of 15 years were included in the study. Surgical procedure and post-operative care were the same for all patients. All patients were assessed through the International Knee Society (IKS) scores and range of motion (ROM). A complete radiological study was performed for all patients. Failure was defined as revision of at least one prosthetic component for any cause.

Results

IKS knee and function scores, as well as ROM and leg alignment, significantly improved at the latest follow-up (p ≤ 0.05). No significant differences were found between fixed- and mobile-bearing groups. Seven implant failures were reported; the implant survival rate (overall) was 94.7% at the latest follow-up.

Conclusions

This study showed optimal survivorship of the NexGen LPS, associated with a significant improvement in overall outcomes at a minimum follow-up of 15 years.

Kurtz S, Ong K, Lau E et al (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89:780–785. doi:10.2106/JBJS.F.00222 PubMed

Porter M, Borrof M, Gregg P, et al. (2013) 10th Annual Report 2013-National Joint Registry of England, Wales, and Northern Ireland. http://www.njrcentre.org.uk/njrcentre/Portals/0/Documents/England/Reports/10th_annual_report/NJR 10th Annual Report 2013 B.pdf. Accessed 16 Jun 2016

Lutzner J, Hubel U, Kirschner S et al (2011) Long-term results in total knee arthroplasty a meta-analysis of revision rates and functional outcome. Chirurg 82:618–624. doi:10.1007/s00104-010-2001-8 CrossRefPubMed

Pavone V, Boettner F, Fickert S, Sculco TP (2001) Total condylar knee arthroplasty: a long-term followup. Clin Orthop Relat Res 18–25. 10.1097/00003086-200107000-00005

Park KK, Chang CB, Kang YG et al (2007) Correlation of maximum flexion with clinical outcome after total knee replacement in Asian patients. J Bone Joint Surg (Br) 89:604–608. doi:10.1302/0301-620X.89B5.18117 CrossRef

Pedraza W, Beckmann J, Mayer C et al (2016) Partially loaded plain radiographic measurement to evaluate rotational alignment in total knee arthroplasty. Int Orthop 40:2519–2526. doi:10.1007/s00264-016-3247-7 CrossRefPubMed

Ritter MA, Harty LD, Davis KE et al (2003) Predicting range of motion after total knee arthroplasty. Clustering, log-linear regression, and regression tree analysis. J Bone Joint Surg Am 85–A:1278–1285CrossRefPubMed

Nakano N, Matsumoto T, Muratsu H et al (2014) Results of total knee arthroplasty with NexGen LPS-Flex for osteoarthritis in the valgus knee: a study of 26 patients followed for a minimum of 2 years. Eur J Orthop Surg Traumatol 25:375–380. doi:10.1007/s00590-014-1505-1 CrossRefPubMed

Lachiewicz PF, Soileau ES (2014) Fixation, survival and osteolysis with a modern posterior-stabilized total knee arthroplasty. J Arthroplasty 29:66–70. doi:10.1016/j.arth.2013.05.002 CrossRefPubMed

10.

Oh KJ, Goodman SB, Yang JH (2011) Prospective, randomized study between insall-burstein II and NexGen legacy with a minimum 9-year follow-Up. J Arthroplasty 26:1232–1238. doi:10.1016/j.arth.2010.12.018 CrossRefPubMed

11.

Norman Scott W (2011) Insall & Scott Surgery of the knee, 5th edn. Churchill Livingstone, London

12.

Fuchs R, Mills EL, Clarke HD et al (2006) A third-generation, posterior-stabilized knee prosthesis: early results after follow-up of 2 to 6 years. J Arthroplasty 21:821–825. doi:10.1016/j.arth.2005.10.008 CrossRefPubMed

13.

Nedopil AJ, Howell SM, Hull ML (2017) What clinical characteristics and radiographic one parameters are associated with patellofemoral instability after kinematically aligned total knee arthroplasty? Int Orthop 41:283-291. 10.1007/s00264-016-3287-z

14.

Chen JY, Lee WC, Chan HY et al (2016) Drain use in total knee arthroplasty is neither associated with a greater transfusion rate nor a longer hospital stay. Int Orthop 40:2505–2509. doi:10.1007/s00264-016-3239-7 CrossRefPubMed

15.

Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res (248):13–14

16.

Clarke HD, Fuchs R, Scuderi GR et al (2006) The influence of femoral component design in the elimination of patellar clunk in posterior-stabilized total knee arthroplasty. J Arthroplasty 21:167–171. doi:10.1016/j.arth.2005.05.024 CrossRefPubMed

17.

Koskinen E, Paavolainen P, Ylinen P et al (2010) Mid-term results for three contemporary total knee replacement designs—a comparative study of 104 patients with primary osteoarthritis. Scand J Surg 99:250–255CrossRefPubMed

18.

Ip D, Wu WC, Tsang WL (2003) Early results of posterior-stabilised NexGen legacy total knee arthroplasty. J Orthop Surg (Hong Kong) 11:38–42CrossRef

19.

Tanzer M, Smith K, Burnett S (2002) Posterior-stabilized versus cruciate-retaining total knee arthroplasty: balancing the gap. J Arthroplasty 17:813–819. doi:10.1054/arth.2002.34814 CrossRefPubMed

20.

Kim Y-H, Park J-W, Kim J-S (2012) 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 94:1378–1384. doi:10.2106/JBJS.K.01229 CrossRefPubMed

21.

Bistolfi A, Massazza G, Lee G-C et al (2013) Comparison of fixed and mobile-bearing total knee arthroplasty at a mean follow-up of 116 months. J Bone Joint Surg Am 95, e83. doi:10.2106/JBJS.L.00327 CrossRefPubMed

22.

Bozic KJ, Kinder J, Menegini M et al (2005) Implant survivorship and complication rates after total knee arthroplasty with a third-generation cemented system: 5 to 8 years followup. Clin Orthop Relat Res 430:117–124CrossRef

23.

(2016) Australian Orthopaedic Association National Joint Replacement Registry. https://aoanjrr.sahmri.com/documents/10180/275066/Hip%252C Knee %2526 Shoulder Arthroplasty. Accessed 18 Nov 2016

24.

Roberts VI, Esler CN, Harper WM (2007) A 15-year follow-up study of 4606 primary total knee replacements. J Bone Joint Surg (Br) 89:1452–1456. doi:10.1302/0301-620X.89B11.19783 CrossRef

25.

Lachiewicz PF, Soileau ES (2009) Fifteen-year survival and osteolysis associated with a modular posterior stabilized knee replacement A concise follow-up of a previous report. J Bone Joint Surg Am 91:1419–1423. doi:10.2106/JBJS.H.01351 CrossRefPubMed

26.

Victor J, Ghijselings S, Tajdar F et al (2014) Total knee arthroplasty at 15–17 years: does implant design affect outcome? Int Orthop 38:235–241. doi:10.1007/s00264-013-2231-8 CrossRefPubMed

27.

Guha AR, Debnath UK, Graham NM (2008) Radiolucent lines below the tibial component of a total knee replacement (TKR)—a comparison between single-and two-stage cementation techniques. Int Orthop 32:453–457. doi:10.1007/s00264-007-0345-6 CrossRefPubMed

28.

Kim YH, Choi Y, Kim JS (2010) Osteolysis in well-functioning fixed- and mobile-bearing TKAs in younger patients. Clin Orthop Relat Res 468:3084–3093. doi:10.1007/s11999-010-1336-2 CrossRefPubMedPubMedCentral

Titel: Long-term follow-up of a non-randomised prospective cohort of one hundred and ninety two total knee arthroplasties using the NexGen implant
verfasst von: Alfredo Schiavone Panni
Franceso Falez
Rocco D’Apolito
Katia Corona
Carlo Perisano
Michele Vasso
Publikationsdatum: 22.03.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 6/2017
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3438-x

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Long-term follow-up of a non-randomised prospective cohort of one hundred and ninety two total knee arthroplasties using the NexGen implant