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General Orthopaedics

Two-year functional and clinical outcome of the Legion revision system

The South African Orthopaedic Association (SAOA) 58th Annual Congress



Abstract

Objectives

The aim of this study was to study the short to medium term outcome of a contemporary modular revision knee system used in our centre for managing knee revision arthroplasty.

Methods

Between July 2006 and October 2011, 153 revision cases were done using the Legion revision system. Seventy eight cases completed a 2 years follow up. Preoperative, one and two years follow up scores and radiographic analysis were recorded. Outcome measures included the American Knee Society (AKSS), Oxford (OKS) and WOMAC scores. The American knee society radiographic analysis system was employed to assess assessment standing AP, lateral and skyline views. Figgie's method was used to measure the joint line reproduction. A difference of 5 mm (pre=op/post-op) was deemed satisfactory.

Results

72 patients were included in this study, 38 males and 34 females with a mean age of 71.2 (50–87 yrs.). Mean BMI was 26.03, (Range 11–50). Indications for surgery in these patients were:- aseptic loosening (38), instability (15), persistent pain and stiffness (7), polyarthropathy (1), ligament laxity (7) and infection (4). The mean American Knee scores, and WOMAC scores at 1 year and 2 years follow up showed a significant improvement in pain and function, with WOMAC Pre-op 14 104 39, at 1 year 33.5 170 26 and at 2 years 36.4 178 24. The mean Oxford Knee Score improved from 14/48 pre-operatively to 34/48 at 2yrs (P value < 0.0001). Radiographic assessment showed a mean AP coronal femoral angle of 95.3 degrees (range 89.6–99.9 degrees), coronal tibial angle of 90.1 degrees (Range 85.1–98.8 degrees). The mean sagittal femoral and tibial angles were 88.4 and 90.4 degrees respectively. The joint line level was reproduced in all cases.

Conclusions

The short-term results with the Legion Knee revision system showed significant improvement in functional and pain scores in these patients irrespective of their indications for revision surgery. The system also showed good outcome scores that match or beat published series on revisions. It also showed a good ability to restore joint line

MULTIPLE DISCLOSURES