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Mid-term outcomes of primary constrained condylar knee arthroplasty for severe knee deformity

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Summary

This study aimed to examine the clinical and radiographic outcomes of primary total knee arthroplasy (TKA) with use of NexGen® Legacy® Constrained Condylar Knee (CCK) prosthesis for severe knee deformity. Clinical data of 46 patients (48 knees in total, aged 61 years on average) with severe knee deformity who underwent TKA with NexGen® Legacy® CCK prosthesis between December 2007 and February 2012 were retrospectively analyzed. There were 34 knees with severe valgus with incompetent medial collateral ligament, 11 knees with severe flexion contracture with inability to achieve knee balancing in flexion and extension by posterior soft tissue release, 2 knees with Charcot arthritis with severe varus and bone loss, and 1 with traumatic osteoarthritis with severe varus and ligamentous instability. The mean duration of follow-up was 71 months (range 40–90 months). The New Knee Society scoring (NKSS) system and the Hospital for Special Surgery (HSS) score were used to evaluate the functional and clinical outcomes. Visual Analogue Scale (VAS) was used for pain measurement and Knee Society criteria for evaluation of radiological images. The results showed that, in the total 48 knees, 1 case of loosening due to short-stem tibial component at 3 months post-operatively underwent revision. The 6-year prosthesis survival rate in this cohort was 97.9%. There was no component infection occurring within 6 years. Significant post-operative improvements were found in NKSS and HSS scores. Patient satisfaction was significantly increased. Pain score was decreased significantly. Total functional score was improved from 31.46±11.43 to 86.42±8.87, range of motion (ROM) from 42.42°±23.57° to 95.31°±23.45° and the flexion contracture from 5.31°±7.87° to 0.92°±1.80°. Preoperative radiographic study showed excessive valgus (≥7°) in 37 knees, and varus deformity in 3 knees. Post-operative femorotibial alignment was valgus 3.88°±1.76° in 48 knees. Antero/posterior (A/P) view of X-ray films showed 4 radiolucent lines (RLL) in 48 tibial components. It was concluded that TKA with CCK is effective for the treatment of the severe unstable knee that cannot be balanced by soft tissue.

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Authors and Affiliations

  1. Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Xiao-bo Feng  (冯晓波), Cao Yang  (杨 操), De-hao Fu  (傅德皓), Shu-nan Ye  (叶树楠), Xian-zhe Liu  (刘先哲), Saroj Rai & Shu-hua Yang  (杨述华)

  2. Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Zhe Chen  (陈 喆)

Authors
  1. Xiao-bo Feng  (冯晓波)
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  2. Cao Yang  (杨 操)
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  3. De-hao Fu  (傅德皓)
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  4. Shu-nan Ye  (叶树楠)
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  5. Xian-zhe Liu  (刘先哲)
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  6. Zhe Chen  (陈 喆)
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  7. Saroj Rai
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  8. Shu-hua Yang  (杨述华)
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Corresponding author

Correspondence to Shu-hua Yang  (杨述华).

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Both authors contributed equally to this work.

This work was supported by a grant from the National Nature Science Foundation of China (No. 81371973).

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Feng, Xb., Yang, C., Fu, Dh. et al. Mid-term outcomes of primary constrained condylar knee arthroplasty for severe knee deformity. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 36, 231–236 (2016). https://doi.org/10.1007/s11596-016-1572-0

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  • DOI: https://doi.org/10.1007/s11596-016-1572-0

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