Clin Orthop Surg.  2015 Mar;7(1):62-68. 10.4055/cios.2015.7.1.62.

Total Knee Replacement Arthroplasty with Buechel and Pappas Knee: Minimum 2-Year Follow-up

• Moon KH
• Hong SH
• Hong TH

• KMID: 2069876
• DOI: http://doi.org/10.4055/cios.2015.7.1.62

Abstract

BACKGROUND
Clinical and radiologic evaluation and analyses of the surgeries using Buechel and Pappas (B-P) knee implants.
METHODS
The study was conducted on 60 patients who underwent 94 total knee replacement arthroplasty with B-P knee implants from May 2009 to December 2010. The results were compared to the results of 41 patients who underwent 60 knee joint surgeries using NexGen-LPS implants from January 2008 to August 2009.
RESULTS
The American Knee Society score of the B-P knee group increased from an average of 66.9 (clinical score) and 65.5 (functional score) to 93.4 and 90.3, respectively; while those for the NexGen-LPS group increased from an average of 68.8 (clinical score) and 62.4 (functional score) to 86.3 and 76, respectively. The average ranges of motion of the B-P knee group and the NexGen-LPS group were 119.1degrees and 114.8degrees, respectively, before surgery and improved to 121.0degrees and 123.0degrees at final follow-up after the surgery. The visual analogue scale scores for the B-P knee group and the NexGen-LPS group improved from 4.7 and 4.6 to 1.4 and 1.8, respectively. The flexion contracture also improved from 5.1degrees and 6.3degrees to 0.64degrees and 1.72degrees. The tibio-femoral angle for the B-P knee group and the NexGen-LPS group also improved greatly after the surgery, from varus 0.34degrees and 0.73degrees each to valgus 6.7degrees and 6.9degrees, respectively.
CONCLUSIONS
The evaluation of more than 2 years of total knee replacement arthroplasty using B-P knee implants showed good results. B-P knee implants showed a relatively higher degree of satisfaction in clinical knee score and less intraoperative bone mass removal than NexGen-LPS implants.

Keyword

Buechel and Pappas knee; NexGen-LPS; Total knee arthroplasty

MeSH Terms

Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee/*instrumentation
Female
Follow-Up Studies
Humans
Knee Joint/radiography/*surgery
*Knee Prosthesis
Male
Middle Aged
Osteoarthritis, Knee/radiography/*surgery

Figure

• 

  Fig. 1 Liner, tibial and femoral components of Buechel and Pappas knee.

• 

  Fig. 2 (A) Preoperative X-ray of an osteoarthritis (OA) patient: right knee anteroposterior (AP) view shows medial joint space narrowing and varus deformity. (B) Preoperative X-ray of an OA patient: right knee lateral view. (C) Postoperative X-ray of an OA patient with Buechel and Pappas (B-P) knee implants: right knee AP view shows correction of medial joint space narrowing and varus deformity. (D) Postoperative X-ray of an OA patient with B-P knee implants: right knee lateral view.

Reference

1. Banks S, Bellemans J, Nozaki H, Whiteside LA, Harman M, Hodge WA. Knee motions during maximum flexion in fixed and mobile-bearing arthroplasties. Clin Orthop Relat Res. 2003; (410):131–138.

2. Kim TW, Park SH, Suh JT. Comparison of mobile-bearing and fixed-bearing designs in high flexion total knee arthroplasty: using a navigation system. Knee Surg Relat Res. 2012; 24(1):25–33.

3. Seo SS, Kim CW, Moon SW. A comparison of patella retention versus resurfacing for moderate or severe patellar articular defects in total knee arthroplasty: minimum 5-year follow-up results. Knee Surg Relat Res. 2011; 23(3):142–148.

4. Cooper RE Jr, Trinidad G, Buck WR. Midvastus approach in total knee arthroplasty: a description and a cadaveric study determining the distance of the popliteal artery from the patellar margin of the incision. J Arthroplasty. 1999; 14(4):505–508.

5. Seyler TM, Mont MA, Ragland PS, Kachwala MM, Delanois RE. Sports activity after total hip and knee arthroplasty: specific recommendations concerning tennis. Sports Med. 2006; 36(7):571–583.

6. Ip D, Wu WC, Tsang WL. Early results of posterior-stabilised NexGen Legacy total knee arthroplasty. J Orthop Surg (Hong Kong). 2003; 11(1):38–42.

7. Moon KH, Lee DJ, Lee JS, Kim YT. Total knee replacement arthroplasty with NexGen®-LPS: minimum 5 year follow-up results. J Korean Orthop Assoc. 2011; 46(5):405–411.

8. Lee DC, Sohn OJ. A comparison of mobile-bearing and fixed-bearing total knee arthroplasties in osteoarthritic patients. J Korean Knee Soc. 2007; 19(2):154–160.

9. Choi CH, Kim KW, Sung IH, Park YS. Patient satisfaction interviews after TKA successful rehabilitation achieved and functions still desired by respondents. J Korean Knee Soc. 2006; 18(1):20–25.

10. Lotke PA, Ecker ML. Influence of positioning of prosthesis in total knee replacement. J Bone Joint Surg Am. 1977; 59(1):77–79.

11. Sorrells RB. The rotating platform mobile bearing TKA. Orthopedics. 1996; 19(9):793–796.