Summary
Two hundred and forty-seven consecutive total knee replacements using the Insall-Burstein standard total condylar knee system with 2 years' follow-up were studied. Of the 238 available to follow-up, two were reoperated during the period, owing to infection and traumatic loosening of a tibia component respectively. Seventy-nine patients were operated for rheumatoid arthritis and 94 for osteoarthritis. In assessment of the total therapeutic result, registration of pain, walking ability, range of motion, muscle strength, flexion deformity, valgus-varus deformities, instability, and use of walking aids were included, according to a rating system. Excellent or good results were found in 91.5%; 6.5% were fair, and 2% were poor. There were two cases of infection; one resulted in removal of the prosthesis and an arthrodesis was done. There were four suspected aseptic loosenings, three cases of transient peroneal nerve palsies, and three patients who developed reflex dystrophy.
Zusammenfassung
Die vorliegende Arbeit umfaßt eine Analyse von 247 Eingriffen unter Anwendung des totalen kondylären Kniegelenkersatzsystems nach Insall-Burstein. 238 Gelenke konnten einer zweijährigen Nachuntersuchung unterzogen werden, wobei während dieser Periode, teils wegen einer tiefen Infektion, teils wegen einer traumatischen Lösung der Tibiakomponente, eine Revision von zwei Gelenken vorgenommen worden war. Der Eingriff wurde bei 79 Patienten aufgrund einer rheumatischen Polyarthritis, bei 94 wegen einer degenerativen Arthrose ausgeführt. Der Wertung des funktionellen Endergebnisses lag eine Skala zugrunde, die folgende Elemente beinhaltete: Schmerz, Gehvermögen, Bewegungsausschlag, Muskelkraft, Flexionskontraktur, Varus-Valgus-Fehlstellung, Instabilität und die Verwendung von Gehhilfen. Ein ausgezeichnetes oder gutes Endergebnis erzielten 91.5%, ein zufriedenstellendes 6.5%, und ein schlechtes 2% der Fälle. Zwei Gelenke waren infiziert, bei einem von diesen wurde die Infektion durch eine Arthrodese zur Ausheilung gebracht. Bei 4 Gelenken ergab sich der Verdacht einer aseptischen Lösung, 3 Fälle wiesen eine vorübergehende Peroneusparese und bei 3 Patienten trat eine Reflexdystrophie auf.
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References
Andriacchi TP, Galante JO, Fermier RW (1982) The influence of total knee replacement design on walking and stair climbing. J Bone Joint Surg [Am] 64:1328–1335
Bargren JH, Blaha JD, Freeman MAR (1983) Alignment in total knee arthroplasty. Correlated biomechanical and clinical observations. Clin Orthop 173:178–183
Blaha JD, Insler HP, Freeman MAR, Revel PA, Todd RC (1982) The fixation of a proximal tibial polyethylene prosteses without cement. J Bone Joint Surg [Br] 64:326–335
Cameron HU, McNeice GM (1981) Mechanical failure modes in total knee replacement. Arch Orthop Traumat Surg 98:135–138
Figgie III HE, Davy DT, Heiple KG, Hart RT (1984) Load-bearing capacity of the tibial component of the total condylar knee prosthesis. An in vitro study. Clin Orthop 183:288–297
Hood RW, Vanni M, Insall JN (1981) The correction of knee alignment in 225 consecutive total condylar knee replacements. Clin Orthop 160:94–105
Hungerford DS, Kenna RV, Krakow KA (1982) The porous-coated anatomic total knee. Orthop Clin Am 13:103–122
Hvid I, Nielsen S (1984) Total condylar knee arthroplasty. Prostetic component positioning and radiolucent lines. Acta Orthop Scand 55:160–165
Insall JN, Burstein AH (1979) Knee replacement using the Insall/Burstein total condylar knee system. HSS instruction booklet, New York
Insall JN, Ranawat CS, Aglietti P, Shine J (1976) A comparison of four models of total knee replacement prostheses. J Bone Joint Surg [Am] 58:754–765
Insall JN, Scott WN, Ranawat CS (1979) The total condylar knee prosthesis. A report of 220 cases. J Bone Joint Surg [Am] 61:173–180
Insall JN, Hood RW, Flawn LB, Sullivan DJ (1983) The total condylar knee prosthesis in gonarthrosis. A 5–9 year follow-up of the first 100 consecutive replacements. J Bone Joint Surg [Am] 65:619–628
Insall JN, Lachiewicz PF, Burstein AH (1982) The posterior stabilized condylar prosthesis: A modification of the total condylar design. Two-to-four year's clinical experience. J Bone Joint Surg [Am] 64:1317–1323
Kettelkamp DB, Nasca R (1973) Biomechanics and knee replacement arthroplasty. Clin Orthop 94:8–14
Laskin RS (1981) Total condylar knee replacement in rheumatoid arthritis. A review of 117 knees. J Bone Joint Surg [Am] 63:29–35
Lotke PA, Ecker ML (1977) Influence of positioning of prosthesis in total knee replacement. J Bone Joint Surg [Am] 59:77–79
Marmor L (1979) Marmor modular knee in unicompartmental disease. Minimum 4-year follow-up. J Bone Joint Surg [Am] 61:347–353
Murray RP, Hayes WC, Edwards WT, Harry JD (1984) Mechanical properties of the subchondral plate and the metaphyseal shell. Trans ORS 8:197
Ritter MA, Gioe TJ, Stringer EA, Littrell D (1984) The posterior cruciate condylar total knee prosthesis. A 5-year follow-up study. Clin Orthop 184:264–269
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Nielsen, S., Hvid, I. & Sneppen, O. Total condylar knee arthroplasty. Arch. Orth. Traum. Surg. 104, 227–232 (1985). https://doi.org/10.1007/BF00450215
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DOI: https://doi.org/10.1007/BF00450215