No Difference in Clinical and Radiologic Outcomes After Total Knee Arthroplasty With a New Ultra-Congruent Mobile Bearing System and Rotating Platform Mobile Bearing Systems After Minimum 5-Year Follow-Up

doi:10.1016/j.arth.2014.09.025

The Journal of Arthroplasty

Volume 30, Issue 3, March 2015, Pages 379-383

https://doi.org/10.1016/j.arth.2014.09.025 Get rights and content

Abstract

We retrospectively compared the clinical and radiographic results between 76 primary total knee arthroplasties (TKAs) using the e.motion Ultra-Congruent prosthesis and 155 primary TKAs using the Low Contact Stress rotating platform. All patients had a minimum 5-year follow-up. Range of motion, Hospital for Special Surgery score, Knee Society Knee Score and Knee Society Functional Score significantly increased in both groups postoperatively, but there was no significant difference between the two groups. The mechanical femorotibial angle improved in both groups postoperatively. Coronal and sagittal component angles were well maintained at the final follow-up. This study demonstrates that a new mobile-bearing prosthesis, designed to be highly congruent with a rotating bearing, could be considered with theoretical advantages and comparable outcomes of established mobile-bearing prostheses.

Section snippets

Materials and Methods

This retrospective comparative study of the e.motion UC and the LCS RP was performed according to the guidelines of the Institutional Review Board of our institution (C2013192(1152)/Chung-Ang Univ. Hospital).

Clinical Results

Clinical results of both groups are summarized in Table 2. Flexion contractures were significantly improved at final follow-up in both groups (P < 0.05). Further flexions were not significantly decreased at final follow-up in both group (P = 0.26, 0.11). However, preoperative ROM and ROM at final follow-up were not statistically different between the two groups (P = 0.82). KSKS and KSFS significantly improved from preoperative values in both groups (P < 0.001). KSKS and KSFS did not differ

Discussion

This paper describes the short-term results of TKAs in 76 knees of 76 patients, using the e.motion UC type prosthesis with a rotating meniscal component and highly congruent design. Primary TKAs with the e.motion UC type prosthesis achieved satisfactory short-term outcomes, with reliable clinical and radiologic results.

The objectives of this rotating platform design are to reduce the bearing dislocation, polyethylene wear, and kinematic limitations associated with traditional rotating platform

Conclusion

This study describes the clinical and radiological results of the e.motion UC prosthesis compared to the established mobile-bearing prosthesis (LCS RP) with a minimum 5-year follow-up. If appropriate surgical techniques are employed, the e.motion UC prosthesis provides satisfactory clinical performance comparable with that of the established mobile-bearing prosthesis. However, further studies of the long-term durability and functioning of this implant are necessary.

Conflict of Interest Statement

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Cited by (19)

Press-Fit Dual-Pivot Total Knee Arthroplasty: Early Results With a Minimum 2-Year Follow-Up
2022, Journal of Arthroplasty
Citation Excerpt :
UC tibial polyethylene inserts can reduce the variability of in vivo knee joint kinematics even in the absence of a classic cam and post mechanism [39,40,48], potentially improving patient satisfaction. A number of studies have demonstrated equivocal clinical and radiographic results at midterm follow-up using UC tibial inserts in TKA, compared with conventional articulations [39–47]. However, Kim et al. specifically noted less noise generation in UC TKAs when compared with a posterior-stabilized TKA group with no differences in side-to-side preference, patient satisfaction, or FJSs [73].
Ultracongruent (UC) tibial bearings are being used with increasing frequency in the United States. Evidence suggests that the use of certain UC bearings may lead to improved patient satisfaction when compared with using conventional inserts. However, little is known as to what effect the use of UC tibial inserts has on bone ingrowth in uncemented total knee arthroplasty (TKA). The purpose of this study was to determine the early clinical and radiographic results of TKA using a press-fit dual-pivot design.
Between 2017 and 2019, a consecutive series of 232 TKAs were implanted using a press-fit tibial and femoral component and a UC dual-pivot tibial insert. Sixty-two percent of patients were male. The average age was 56 years. Patients were followed for a minimum of 2 years (range, 24-42 months) using KOOS-JR and Knee Society clinical and radiographic evaluation.
No patient had more than mild knee stiffness at the final follow-up. Two patients reported moderate knee pain with stair climbing. All other patients reported either mild or no pain with activity. Knee Society pain scores averaged 42 points. Flexion averaged 118 degrees. Three knees (1.3%) were revised (one each for flexion instability, tibial plateau fracture, and suspected femoral component loosening). No other cases of femoral or tibial loosening were identified.
Although the success of uncemented TKA is determined by a variety of factors, the use of this dual-pivot knee design did not appear to influence tibial or femoral component fixation at early follow-up, yielding acceptable clinical and radiographic outcomes.
Progressive Tibial Bearing Sagittal Plane Conformity in Cruciate-Retaining Total Knee Arthroplasty
2021, Journal of Arthroplasty
Citation Excerpt :
The PCL was excised in all cases. Ko et al [18] also evaluated 76 e.Motion TKAs where the PCL was excised and compared the results to 155 LCS TKAs and found similar KS, PNS, and FS. These studies also support the notion that using an UC insert is a viable option when the PCL is found to be nonfunctional at the time of surgery.
We hypothesized that when the posterior cruciate ligament (PCL) is found deficient at total knee arthroplasty (TKA), using an anterior-stabilized (AS) tibial insert would provide similar function and survivorship when compared to using a more traditional cruciate-retaining (CR) bearing when the (PCL) is balanced.
A total of 1731 TKAs were performed using the same TKA design. Of them, 868 TKAs had a standard CR insert implanted (CR-S), 480 TKAs used a lipped CR insert (CR-L), and 383 TKAs used an AS insert. If the PCL was considered nonfunctional or absent, an AS bearing was placed. When the PCL was balanced, a CR-S or CR-L bearing was used. Follow-up was performed using the Knee Society scoring system. Kaplan-Meier survivorship was used with failure defined as aseptic loosening.
At final follow-up, there were no significant differences in knee flexion, pain, function, or stair scores. Walking scores were significantly lower in the AS group. Posterior instability was higher in the CR-S group, whereas the manipulation rate was highest in the CR-L group (1.7%, 1.3%, and 0% for CR-L, CR-S, and AS groups, respectively). Kaplan-Meier survivorship at 5 years demonstrated no significant difference between the 3 groups (99% 100%, and 99% for CR-S, CR-L, and AS groups, respectively).
Using an AS insert provided similar function and 5-year survivorship as compared to using a CR-S and CR-L tibial insert when the PCL was balanced. Using an ultracongruent AS dished tibial component appears to be a reasonable option when the PCL is completely released or found deficient at operation.
Long term results of total knee arthroplasties
2018, Bulletin de l'Academie Nationale de Medecine
Les données actuelles concernant les prothèses totales du genou retrouvent un nombre d’intervention en croissance continue. Ce chapitre présente les résultats actuels à long terme de cette intervention, aussi bien sur le plan de la survie des implants que sur l’aspect fonctionnel. L’influence du chirurgien, du patient et de la prothèse sur ces résultats sont évoqués, ainsi que les stratégies actuelles et futures pour essayer d’améliorer encore ces résultats.
Current data on total knee arthroplasties show a steady increase in the number of procedures. This chapter presents the current long-term results of this procedure, both in terms of implant survival and functional outcome. The influence of surgeon, patient and prosthesis design on these results are discussed, as well as current and future strategies to try to further improve these results.
Functional Outcomes of a New Mobile-Bearing Ultra-Congruent TKA System: Comparison With the Posterior Stabilized System
2015, Journal of Arthroplasty
Citation Excerpt :
This interesting finding is in agreement with previous studies reporting only a weak correlation between the postoperative maximum flexion and the clinical parameters for pain relief, joint function, and quality of life [41,42]. This study, along with previous midterm studies of TKAs performed with the e.motion-UC [38–40], indicates that the mobile-bearing UC prosthesis provides satisfactory functional outcomes. Our longitudinal comparisons revealed that knees treated with the e.motion-UC exhibited a faster recovery pattern than knees treated with the e.motion-PS.
We determined whether a new mobile-bearing ultra-congruent (UC) TKA system provides better functional outcomes than an established posterior-stabilized (PS) prosthesis. The functional outcomes (motion arc, AKS scores, WOMAC Index, and SForm-36 scores evaluated at 1 and 2 years postoperatively), satisfaction and incidences of adverse events were compared between the knees implanted with mobile-bearing UC prosthesis (n = 103) and the mobile-bearing PS prosthesis (n = 99). At 2 years, mobile-bearing UC TKAs showed similar functional outcomes and satisfaction, but smaller motion arc compared to mobile-bearing PS TKAs (126° vs. 131°). There were no differences in the incidence of adverse events. Mobile-bearing UC prosthesis can be considered a safe and viable alternative to the PS design, with an expectation of smaller postoperative maximum flexion.
Clinical relevance of roll-back replacement of ultra congruent total knee arthroplasty: comparison of mid-term outcomes with posterior stabilizing design
2023, Archives of Orthopaedic and Trauma Surgery
Comparison of ultra-congruent anterior-stabilized vs. a posterior cruciate substituting total knee arthroplasty for osteoarthritis with severe varus knee deformity: comparable 2 year outcomes with two design
2023, European Review for Medical and Pharmacological Sciences

View all citing articles on Scopus

: The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2014.09.025.

View full text

No Difference in Clinical and Radiologic Outcomes After Total Knee Arthroplasty With a New Ultra-Congruent Mobile Bearing System and Rotating Platform Mobile Bearing Systems After Minimum 5-Year Follow-Up

Abstract

Section snippets

Materials and Methods

Clinical Results

Discussion

Conclusion

J Arthroplasty

J Arthroplasty

J Arthroplasty

J Arthroplasty

Knee

J Arthroplasty

Knee

J Arthroplasty

J Arthroplasty

Knee

J Orthop Res

Knee

Mobile-bearing knee replacement: concepts and results

Instr Course Lect

Mobile-bearing total knee arthroplasty: design factors in minimizing wear

Clin Orthop Relat Res

Comparison of a new mobile-bearing total knee prosthesis with a fixed-bearing prosthesis: a matched pair analysis

Arch Orthop Trauma Surg

Mid-term results with a highly congruous mobile-bearing knee prosthesis

Knee Surg Sports Traumatol Arthrosc