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Does a non-stemmed constrained condylar prosthesis predispose to early failure of primary total knee arthroplasty?

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The use of unlinked constrained condylar components (CCK) has been extended to primary total knee arthroplasty (TKA); however, there is limited literature on its outcomes. The purpose of this retrospective cohort study was to assess clinical outcomes of one particular design of primary, non-stemmed, unlinked constrained TKA and to compare them with a control group of PS-TKA utilizing the same implant design.

Methods

The clinical and radiographic outcomes of 486-cemented, non-stemmed, primary TKA’s performed by two surgeons at one institution using similar surgical algorithm, technique and prosthetic design were retrospectively reviewed. Primary TKA components were used in all knees; the only difference between groups was the type of polyethylene inserts used (CCK vs PS). Pre-operative deformity, knee society scores (KSS), range-of-motion (ROM), radiographic data and revision rates were compared.

Results

Both groups had comparable demographics, pre-operative coronal plane alignment, ROM and KSS. At a mean follow-up of 3.5 years, no difference was found in ROM, KSS, radiographic outcomes and revision rates.

Conclusions

Cemented, primary, non-stemmed CCK-TKA offered comparable clinico-radiographic results to PS-TKA at short-term follow-up. Use of a semi-constrained insert without additional stems did not predispose to failure due to aseptic loosening with this implant design. Moreover, the rate of revision due to instability was lowered.

Level of evidence

Retrospective cohort study, Level III.

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References

  1. Anderson JA, Baldini A, MacDonald JH, Pellicci PM, Sculco TP (2006) Primary constrained condylar knee arthroplasty without stem extensions for the valgus knee. Clin Orthop Relat Res 442:199–203

    Article  PubMed  Google Scholar 

  2. Anderson JA, Baldini A, MacDonald JH, Tomek I, Pellicci PM, Sculco TP (2007) Constrained condylar knee without stem extensions for difficult primary total knee arthroplasty. J Knee Surg 20:195–198

    PubMed  Google Scholar 

  3. Callaghan JJ, Beckert MW, Hennessy DW, Goetz DD, Kelley SS (2013) Durability of a cruciate-retaining TKA with modular tibial trays at 20 years. Clin Orthop Relat Res 471:109–117

    Article  PubMed  Google Scholar 

  4. Cameron H, Hunter G (1982) Failure in total knee arthroplasty: mechanisms, revisions and results. Clin Orthop Relat Res 170:141–146

    PubMed  Google Scholar 

  5. Dixon MC, Brown RR, Parsch D, Scott RD (2005) Modular fixed-bearing total knee arthroplasty with retention of the posterior cruciate ligament. A study of patients followed for a minimum of fifteen years. J Bone Joint Surg Am 87:598–603

    Article  PubMed  Google Scholar 

  6. Easley ME, Insall JN, Scuderi GR, Bullek DD (2000) Primary constrained condylar knee arthroplasty for the arthritic valgus knee. Clin Orthop Relat Res 380:58–64

    Article  PubMed  Google Scholar 

  7. Ewald FC (1989) The knee society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12

    PubMed  Google Scholar 

  8. Fehring TK, Odum S, Griffin WL, Mason JB, Nadaud M (2001) Early failures in total knee arthroplasty. Clin Orthop Relat Res 392:315–318

    Article  PubMed  Google Scholar 

  9. Hartford JM, Goodman SB, Schurman DJ, Knoblick G (1998) Complex primary and revision total knee arthroplasty using the condylar constrained prosthesis: an average 5-year follow-up. J Arthroplasty 13:380–387

    Article  CAS  PubMed  Google Scholar 

  10. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14

    PubMed  Google Scholar 

  11. King B, Gladnick BP, Lee Y, Lyman S, Della Valle AG (2014) Range of motion and function are not affected by increased post constraint in patients undergoing posterior stabilized total knee arthroplasty. Knee 21(1):194–198

    Article  PubMed  Google Scholar 

  12. Lachiewicz PF, Soileau ES (2006) Ten-year survival and clinical results of constrained components in primary total knee arthroplasty. J Arthroplasty 21:803–806

    Article  PubMed  Google Scholar 

  13. Lachiewicz PF, Soileau ES (2011) Results of a second generation constrained condylar prosthesis in primary total knee arthroplasty. J Arthroplasty 26:1228–1231

    Article  PubMed  Google Scholar 

  14. Lee RW, Volz RG, Sheridan DC (1991) The role of fixation and bone quality on the mechanical stability of total knee components. Clin Orthop Relat Res 273:177–183

    PubMed  Google Scholar 

  15. Meftah M, Ranawat AS, Sood AB, Rodriguez JA, Ranawat CS (2012) All-Polyethylene tibial implant in young, active patients. A concise follow-up, 10 to 18 years. J Arthroplasty 27:10–14

    Article  PubMed  Google Scholar 

  16. Morgan H, Battista V, Leopold SS (2005) Constraint in primary total knee arthroplasty. J Am Acad Orthop Surg 13:515–524

    Article  PubMed  Google Scholar 

  17. Nam D, Umunna BP, Cross MB, Reinhardt KR, Duggal S, Cornell CN (2012) Clinical results and failure mechanisms of a nonmodular constrained knee without stem extensions. HSS J 8:96–102

    Article  PubMed  PubMed Central  Google Scholar 

  18. Rawlinson JJ, Closkey RF Jr, Davis N, Wright TM, Windsor R (2008) Stemmed implants improve stability in augmented constrained condylar knees. Clin Orthop Relat Res 466:2639–2643

    Article  PubMed  PubMed Central  Google Scholar 

  19. Rawlinson JJ, Peters LE, Campbell DA, Windsor R, Wright TM, Bartel DL (2005) Cancellous bone strains indicate efficiency of stem augmentation in constrained condylar knees. Clin Orthop Relat Res 440:107–116

    Article  PubMed  Google Scholar 

  20. Rodriguez JA, Bhende H, Ranawat CS (2001) Total condylar knee replacement: a 20-year followup study. Clin Orthop Relat Res 388:10–17

    Article  PubMed  Google Scholar 

  21. Sculco TP (2006) The role of constraint in total knee arthroplasty. J Arthroplasty 21:54–56

    Article  PubMed  Google Scholar 

  22. Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM (2002) Insall award paper: why are total knee arthroplasties failing today? Clin Orthop Relat Res 404:7–13

    Article  PubMed  Google Scholar 

  23. Shen C, Lichstein PM, Austin MS, Sharkey PF, Parvizi J (2014) Revision knee arthroplasty for bone loss: choosing the right degree of constraint. J Arthroplasty 29(1):127–131

    Article  PubMed  Google Scholar 

  24. Vasso M, Beaufils P, Schiavone Panni A (2013) Constraint choice in revision knee Arthroplasty. Int Orthop 37:1279–1284

    Article  PubMed  PubMed Central  Google Scholar 

  25. Vanin N, Panzica M, Dikos G, Krettek C, Hankemeier S (2011) Rotational alignment in total knee arthroplasty: intraoperative inter-and intraobserver reliability of Whiteside’s line. Arch Orthop Trauma Surg 131:1477–1480

    Article  PubMed  Google Scholar 

  26. Wing CK, Kwok-Hing C (2012) Sixteen years’ result of posterior-stabilized TKA. J Knee Surg 25:245–248

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. NYU Hospital For Joint Diseases, NYU Langone Medical Center, 301 E 17th Street, New York, NY, 10003, USA

    Ajit J. Deshmukh, Parthiv A. Rathod, Michael J. Moses, Nimrod Snir, Scott E. Marwin & Alan J. Dayan

  2. VA New York Harbor Healthcare System, 423 E 23rd Street, New York, NY, 10010, USA

    Ajit J. Deshmukh

Authors
  1. Ajit J. Deshmukh
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  2. Parthiv A. Rathod
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  3. Michael J. Moses
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  4. Nimrod Snir
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  5. Scott E. Marwin
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  6. Alan J. Dayan
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Correspondence to Ajit J. Deshmukh.

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Deshmukh, A.J., Rathod, P.A., Moses, M.J. et al. Does a non-stemmed constrained condylar prosthesis predispose to early failure of primary total knee arthroplasty?. Knee Surg Sports Traumatol Arthrosc 24, 3194–3199 (2016). https://doi.org/10.1007/s00167-014-3494-3

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  • DOI: https://doi.org/10.1007/s00167-014-3494-3

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