Document Detail

Primary posterior cruciate-retaining total knee arthroplasty: a comparison of American and Japanese cohorts.
MedLine Citation:
PMID:  18053397     Owner:  NLM     Status:  MEDLINE    
Excessive polyethylene wear is recognized as one of the most important factors affecting the durability of total knee arthroplasty; however, bearing surface wear is a multifactorial problem. The purpose of this study was to identify factors for polyethylene wear and failure in primary posterior cruciate-retaining (PCR) total knee arthroplasty (TKA) in two disparate cohorts (American and Japanese). Seventy-three total knee arthroplasty operations were performed on 48 Japanese patients, and 76 on 63 American patients with noninflammatory arthritides. All patients were evaluated clinically and radiographically using a total joint arthroplasty database. Age, weight, diagnosis, Knee Society patient category, prosthesis size, insert thickness, alignment, polyethylene wear, osteolysis, Knee Society knee score, Knee Society pain score, and radiographic and clinical survivorship were evaluated. Seventy-three Japanese TKAs were followed for a mean of 6.6 years (range, 2.0-10.6). Three (4.1%) Japanese patients required revision. Seventy-six American TKAs were followed for a mean of 9 years (range, 2-10.2). Two (2.6%) American patients required revision. The American patients were significantly older, heavier, male predominant, and required larger size implants. The Japanese patients were significantly more female predominant and had a significantly less postoperative arc of motion. Knee Society knee and pain scores, survivorship, average total polyethylene wear, and annual wear rates were not different among the two cohorts. PCR TKA had similar survivorship in disparate cohorts of Japanese and American total knee arthroplasty patients despite smaller stature patients in the Japanese cohort. Cultural, gender-specific, and morphologic differences need to be considered for knee implant design. However, survivorship and polyethylene wear rates appear to be independent of these factors in disparate populations.
Richard Iorio; Seneki Kobayashi; William L Healy; Aristides I Cruz; Michael E Ayers
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of surgical orthopaedic advances     Volume:  16     ISSN:  1548-825X     ISO Abbreviation:  J Surg Orthop Adv     Publication Date:  2007  
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101197881     Medline TA:  J Surg Orthop Adv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  164-70     Citation Subset:  IM    
Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805, USA.
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MeSH Terms
Aged, 80 and over
Arthroplasty, Replacement, Knee / methods*
Cohort Studies
Follow-Up Studies
Joint Prosthesis*
Middle Aged
Osteoarthritis / surgery
Osteolysis / etiology
Pain Measurement
Polyethylene / chemistry
Posterior Cruciate Ligament / physiology*
Postoperative Complications
Prosthesis Design
Prosthesis Failure
Range of Motion, Articular / physiology
Surface Properties
United States
Reg. No./Substance:

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