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Results of total knee replacement with a cruciate-retaining model for severe valgus deformity-A study of 48 patients followed for an average of 9years.
MedLine Citation:
PMID:  20471274     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The objectives of the present study were to find out the results and the factors affecting survival after primary knee arthroplasty with a cruciate-retaining prosthesis in severe valgus deformity. Forty-eight patients (52 knees) participated in the current follow-up study. All patients were followed at least 5years or to first revision. Mean follow-up time was 9years (range, 1 to 17years).The Kaplan-Meier analysis revealed 79% (95% CI 68% to 91%) survival rate with revision for any reason and 81% (95% CI 70% to 93%) survival rate with revision for instability as an endpoint at 10years. Preoperatively TFA was 23° (range, 15°-51°) in valgus and 7° (range, 21° valgus-4° varus) in valgus postoperatively. Of the 14 re-operated patients, eight were revised because of progressive postoperative medial collateral ligament instability. All re-operations were performed during the first 4years of the follow-up. The mean TFA was 15.5° valgus postoperatively for those eight and the odds ratio for a revision was 2 (95% CI 1-3, p=0.025) when compared to the rest of the study population. The residual valgus deformity increases the risk of re-operation and it should be avoided. If proper soft-tissue balance cannot be achieved or there is no functional medial collateral ligament present more constrained implants should be used. In selected cases where both bony correction and ligament balancing have properly been achieved the use of a cruciate-retaining type of prosthesis is justified.
Authors:
Esa Koskinen; Ville Remes; Pekka Paavolainen; Arsi Harilainen; Jerker Sandelin; Kaj Tallroth; Jyrki Kettunen; Pekka Ylinen
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Publication Detail:
Type:  Journal Article     Date:  2010-05-14
Journal Detail:
Title:  The Knee     Volume:  18     ISSN:  1873-5800     ISO Abbreviation:  Knee     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-04-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9430798     Medline TA:  Knee     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  145-50     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier B.V. All rights reserved.
Affiliation:
ORTON Research Institute, ORTON Foundation, Helsinki, Finland.
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