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General Orthopaedics

THE POSTERIOR STABILISED KNEE: NO POST REQUIRED – OPPOSES

Current Concepts in Joint Replacement (CCJR) – Winter 2013



Abstract

Introduction

Proper balance and stability is essential to the longevity of total knee arthroplasty (TKA). The aim of this study was to evaluate long-term quality and performance of cemented total knee arthroplasty (TKA) in young and active patients using posterior stabilised designs.

Methods

From a prospective database between January 2000 and October 2001, 62 patients (81 TKAs, mean age 53 ± 1.5 years) with University of California Los Angeles (UCLA) activity score of 5 or above were identified. All implants received Posterior-Stabilised (PS) TKA: 43 Rotating-Platform (RP-PS) and 38 Fixed-Bearing (FB-PS) and were followed prospectively for a minimum of 10 years. The femoral component was identical in both groups and all TKAs were cemented. Extension first gap balancing technique was utilised in all cases.

Results

There was no malalignment, patellofemoral maltracking, aseptic loosening or osteolysis at final follow-up. The final mean ROM in RP-PS and FB-PS was 117 and 114 degrees, respectively. There was no case of early or late flexion instability or spinout. 79% of patients had high functional scores at final follow-up and 92% were satisfied. The results of the MRI study showed that the mean femoral rotation in the RP-PS and the FB-PS knees was 2 degrees and 3 degrees, respectively. The tibial base plate rotation compared to the most prominent point of the tibial tubercle was 0.4 degrees and 0.1 degrees of external rotation in RP-PS and FB-PS knees, respectively.

Conclusion

The PS TKA in young and active patients can provide long-term durability and high quality of function.