Literature DB >> 18075748

Tension controlled ligament balanced total knee arthroplasty: 5-year results of a soft tissue orientated surgical technique.

Tobias Wyss1, Andreas J Schuster, Bernhard Christen, Ulrich Wehrli.   

Abstract

INTRODUCTION: Posterior cruciate ligament (PCL)-retaining prostheses give good outcomes and are commonly used. This retrospective study investigated outcomes from total knee arthroplasty (TKA) using the ligament balancing technique to implant a PCL-retaining knee prosthesis (balanSystrade mark knee system) with either a mobile or a fixed bearing polyethylene inlay.
MATERIALS AND METHODS: A retrospective study was performed on patients treated with TKA at one surgical centre between 1997 and 2001. In this period 182 surgeries were performed. Clinical assessments of the implant used the Knee Society Score (KSS). Subjective assessments used visual analogue scale (VAS) for pain and patient satisfaction. The Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) was used to assess pain, stiffness and function of the knee. Radiographic analysis was performed to determine frontal and sagittal alignment and loosening.
RESULTS: A total of 109 knee implants in 95 patients (26 men; 69 women) were followed up. Seventy-three cases were not available for follow-up due to bad health or death of the patient; 74% of 109 reviewed implants had fixed bearings and 26% had mobile bearings. The mean age at surgery was 72.9 +/- 7.35 years (range 54.7-92.4). The mean KSS was 160 +/- 28.3 points. The KSS was greater for men and was significantly reduced when another disease was present. The type of bearing, surgical approach, and pre-operative alignment for patients affected by varus or valgus gonarthrosis had no significant impact on KSS and ROM. According to VAS the mean scores for pain and satisfaction were 1.48 (0 = no pain) and 9.2 (10 = very satisfied), respectively. The WOMAC mean scores for pain (87.0), stiffness (82.3) and function (78.6) were high (best outcome score of 100). There were no revisions due to aseptic loosening or wear.
CONCLUSION: Total knee arthroplasty performed with a PCL-retaining prosthesis implanted by using a soft tissue oriented surgical technique is a safe procedure and was associated with good results. So far, there were few complications and no need for revision due to aseptic loosening. In addition, most of the patients reported little pain and were satisfied with the outcome. These good outcomes are comparable with other studies reporting on PCL-retaining prostheses.

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Year:  2007        PMID: 18075748     DOI: 10.1007/s00402-007-0541-2

Source DB:  PubMed          Journal:  Arch Orthop Trauma Surg        ISSN: 0936-8051            Impact factor:   3.067


  14 in total

1.  Ligament tension in the ACL-deficient knee: assessment of medial and lateral gaps.

Authors:  David Mayman; Christopher Plaskos; Daniel Kendoff; G Wernecke; Andrew D Pearle; Richard Laskin
Journal:  Clin Orthop Relat Res       Date:  2009-02-24       Impact factor: 4.176

2.  Relationship between joint gap difference and range of motion in total knee arthroplasty: a prospective randomised study between different platforms.

Authors:  Hiroshi Higuchi; Kazuhisa Hatayama; Masaki Shimizu; Atsushi Kobayashi; Tsutomu Kobayashi; Kenji Takagishi
Journal:  Int Orthop       Date:  2009-04-28       Impact factor: 3.075

3.  Influence of the anterior-posterior femoral translation on the range of motion in cruciate-retaining total knee arthroplasty.

Authors:  Shinya Yanagisawa; Naoki Sato; Takashi Ohsawa; Kenichi Saito; Masaki Shimizu; Kenji Takagishi
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2013-06-22       Impact factor: 4.342

4.  The influence of coronal plane deformity on mediolateral ligament status: an observational study in varus knees.

Authors:  Johan Bellemans; H Vandenneucker; J Vanlauwe; J Victor
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2010-02       Impact factor: 4.342

5.  Patient-related factors influence stiffness of the soft tissue complex during intraoperative gap balancing in cruciate-retaining total knee arthroplasty.

Authors:  P J C Heesterbeek; N Haffner; A B Wymenga; J Stifter; P Ritschl
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2015-07-15       Impact factor: 4.342

6.  Anteroposterior stability after posterior cruciate-retaining total knee arthroplasty.

Authors:  A J Schuster; A L von Roll; D Pfluger; T Wyss
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2011-01-14       Impact factor: 4.342

7.  [Ligament-controlled positioning of the knee prosthesis components].

Authors:  K-H Widmer; A Zich
Journal:  Orthopade       Date:  2015-04       Impact factor: 1.087

8.  Superior long-term survival for fixed bearing compared with mobile bearing in ligament-balanced total knee arthroplasty.

Authors:  P J C Heesterbeek; A H van Houten; J S Klenk; H Eijer; B Christen; A B Wymenga; A J Schuster
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2017-04-07       Impact factor: 4.342

9.  Intraoperative joint gaps affect postoperative range of motion in TKAs with posterior-stabilized prostheses.

Authors:  Toshifumi Watanabe; Takeshi Muneta; Ichiro Sekiya; Scott A Banks
Journal:  Clin Orthop Relat Res       Date:  2012-12-19       Impact factor: 4.176

10.  Different femorotibial contact points between fixed- and mobile-bearing TKAs do not show clinical impact.

Authors:  R A van Stralen; P J C Heesterbeek; A B Wymenga
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2014-07-20       Impact factor: 4.342

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