Document Detail

No better flexion or function of high-flexion designs in Asian patients with TKA.
MedLine Citation:
PMID:  23054522     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recently, high-flexion PCL-retaining (CR) and -substituting (PS) knee prostheses were designed to allow greater and safer flexion after TKA. However, the advantages of high-flexion TKA over standard design have been debated in terms of early maximal flexion. A recent study reported a high incidence of early loosening of the femoral component related to the deep flexion provided by high-flexion PS TKA.
QUESTIONS/PURPOSES: We determined whether high-flexion fixed bearing CR and PS prostheses would provide (1) a better flexion, (2) a better function, and (3) a higher incidence of radiographic loosening than TKA performed using standard fixed bearing CR prostheses in Asian patients.
METHODS: From a total of 182 patients with primary unilateral TKA, we retrospectively reviewed 137 TKAs: 47 with high-flexion CR, 42 with high-flexion PS, and 48 with standard CR designs. ROM, Knee Society scores, and WOMAC scores were evaluated and compared among the three groups. Radiographically, we assessed radiolucent zones and component loosening. Minimum followup was 5 years (mean, 6.2 years; range, 5-8 years).
RESULTS: We found no differences among the three groups in mean maximal flexion (high-flexion CR: 135°; high-flexion PS: 134°; standard CR: 136°), Knee Society scores, and WOMAC scores at last followup. Also, there were no differences among the three groups in terms of radiolucent lines around the prosthesis. No patient in any group had loosening of the femoral component.
CONCLUSIONS: The high-flexion CR or PS design had no advantages over the standard CR design with respect to ROM, clinical scores, and radiolucent lines around the femoral or tibial component after 5 years' followup.
Jong-Keun Seon; Ji-Hyeon Yim; Hyoung-Yeon Seo; Eun-Kyoo Song
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-02     Completed Date:  2013-05-22     Revised Date:  2014-05-08    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1498-503     Citation Subset:  AIM; IM    
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MeSH Terms
Analysis of Variance
Arthroplasty, Replacement, Knee* / instrumentation
Asian Continental Ancestry Group*
Biomechanical Phenomena
Chi-Square Distribution
Disability Evaluation
Knee Joint / physiopathology,  radiography,  surgery*
Knee Prosthesis
Prosthesis Design
Prosthesis Failure
Range of Motion, Articular
Recovery of Function
Republic of Korea / epidemiology
Retrospective Studies
Time Factors
Treatment Outcome

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

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