Document Detail


Knee arthroplasty with a medially conforming ball-and-socket tibiofemoral articulation provides better function.
MedLine Citation:
PMID:  20700674     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A knee design with a ball-and-socket articulation of the medial compartment has a femoral rollback profile similar to the native knee. Compared to a conventional, posterior-stabilized knee design, it provides AP stability throughout the entire ROM. However, it is unclear whether this design difference translates to clinical and functional improvement.
QUESTIONS/PURPOSES: We asked whether the medially conforming ball-and-socket design differences would be associated with (1) improved ROM; and (2) improved American Knee Society, WOMAC, Oxford Knee, SF-36, and Total Knee Function Questionnaire scores compared to a conventional, fixed-bearing posterior-stabilized TKA.
PATIENTS AND METHODS: We enrolled 82 patients in a single-center, single-blinded, randomized, controlled trial comparing the medially conforming ball-and-socket design knee prosthesis to a posterior-stabilized total knee prosthesis. Our primary end point was ROM. Our secondary end points were American Knee Society, WOMAC, Oxford Knee, SF-36, and Total Knee Function Questionnaire scores. All patients were followed at 1 and 2 years.
RESULTS: The mean ROM was 100.1° and 114.9° in the posterior-stabilized and medially conforming ball-and-socket groups, respectively. The physical component scores of SF-36 and Total Knee Function Questionnaire were better in the medially conforming ball-and-socket group. We found no difference in American Knee Society, WOMAC, and Oxford Knee scores.
CONCLUSIONS: Both implant designs similarly relieved pain and improved function. The medially conforming ball-and-socket articulation provided better high-end function as reflected by the Total Knee Function Questionnaire.
LEVEL OF EVIDENCE: Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Authors:
Fahad Hossain; Shelain Patel; Shin-Jae Rhee; Fares Sami Haddad
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-01-25     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  55-63     Citation Subset:  AIM; IM    
Affiliation:
Department of Trauma & Orthopaedics, University College Hospital, 235 Euston Road, London NW1 2BU, UK. f.hossain@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee / adverse effects,  instrumentation*
Biomechanics
England
Female
Humans
Knee Joint / physiopathology,  radiography,  surgery*
Knee Prosthesis*
Male
Middle Aged
Pain Measurement
Pain, Postoperative / etiology,  prevention & control
Prospective Studies
Prosthesis Design
Questionnaires
Range of Motion, Articular
Recovery of Function
Single-Blind Method
Time Factors
Treatment Outcome
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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