Clin Orthop Surg.  2015 Mar;7(1):54-61. 10.4055/cios.2015.7.1.54.

Advantage of Minimal Anterior Knee Pain and Long-term Survivorship of Cemented Single Radius Posterior-Stabilized Total Knee Arthroplasty without Patella Resurfacing

• Ji HM
• Ha YC
• Baek JH
• Ko YB

• KMID: 2069875
• DOI: http://doi.org/10.4055/cios.2015.7.1.54

Abstract

BACKGROUND
The single radius total knee prosthesis was introduced with the advantage of reduced patellar symptoms; however, there is no long-term follow-up study of the same. The purpose of this study was to determine the survival rate of single radius posterior-stabilized total knee arthroplasty and patellofemoral complication rates in a consecutive series.
METHODS
Seventy-one patients (103 knees) who underwent arthroplasty without patellar resurfacing using a single radius posterior-stabilized total knee prosthesis were followed up for a minimum 10 years. Clinical evaluation using Knee Society knee and function scores and radiologic evaluation were performed at regular intervals. Anterior knee pain as well as patellofemoral complications were evaluated with a simple questionnaire. The Kaplan-Meier product-limit method was used to estimate survival.
RESULTS
Seventeen patients (23 knees) were excluded due to death (12 knees) or lost to follow-up (11 knees). Of the 80 knees enrolled, all femoral components and 78 tibial components were well fixed without loosening at final follow-up. Two revisions were performed because of tibial component loosening and periprosthetic joint infection. One patient with tibial component loosening refused to have revision surgery. No obvious tibial insert polyethylene wear was observed. The survivorships at 132 months were 96.7% using revision or pending revision as end points. Anterior knee pain was present in 6 patients (6 knees, 7.5%) at the latest follow-up. No patellofemoral complication requiring revision was encountered.
CONCLUSIONS
The single radius posterior-stabilized total knee prosthesis demonstrated an excellent minimum 10-year survivorship. The low rates of implant loosening and 7.5% of anterior knee pain as a patellofemoral complication are comparable with those reported for other modern total knee prosthesis.

Keyword

Arthroplasty; Replacement; Knee; Single-radius; Survival rate

MeSH Terms

Aged
Arthralgia/*surgery
Arthroplasty, Replacement, Knee/*instrumentation/*methods
Cementation
Female
Follow-Up Studies
Humans
Knee Joint/*surgery
Knee Prosthesis
Male
Middle Aged
Patella/surgery
Prosthesis Failure
Retrospective Studies
Treatment Outcome

Figure

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  Fig. 1 A flowchart showing the flow of patients through the study.

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  Fig. 2 Patellar tilt (A) and patella shift (B) were measured from the skyline view.

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  Fig. 3 Kaplan-Meier survival rate in the best-case scenario (with implant revision or loosening as endpoints) was 96.7% (95% confidence intervals [CI], 93.3 to 99.9) and in the worst-case scenario was 86.0% (95% CI, 79.2 to 92.8).

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