J Korean Orthop Assoc.  2008 Dec;43(6):728-737.

Revision Total Knee Arthroplasty using NexGen(R) LCCK with Allograft

• Chun CH
• Kweon SH
• Kim HJ
• Jeong KJ
• Kim KM

Abstract

PURPOSE: To analyze the clinical and radiographic results after revision total knee arthroplasty (TKA) using Nexgen(R) LCCK (Legacy(R) knee constrained condylar knee, Zimmer, Warsaw, IN) with allograft.
MATERIALS AND METHODS
Twenty patients (21 knees) taken revision TKA were analyzed. The average age of the patients was 69.2 years old and the average of follow-up duration was for 2 year to 8 years 2 months (average 3 years 5 months). The clinical result and radiographic measurements were assessed using the Hospital for Special Surgery (HSS) knee rating score and the roentgenographic method of the American Knee Society.
RESULTS
The mean interval from TKA to revision surgery was 6 years 4 months. In all cases, allograft was used. The average range of motion was increased from 93degrees to 107degrees, HSS score was increased from an average of 45 to 87 points. Postoperative femorotibial alignment was averaged 5.7degrees valgus. In all cases, radiolucency was below 4 scores and there was no loosening of implant. But, three radiopaque lines around a stem. There were wound dehiscence in 1 case and superficial infection in 2 cases.
CONCLUSION
Satisfactory results were obtained in revision TKA using a NexGen(R) LCCK with allograft. But, this study is favorable for the long term follow-up.

Keyword

Knee; Revision arthroplasty; Nexgen(R) LCCK; Allograft

MeSH Terms

Arthroplasty
Follow-Up Studies
Humans
Knee
Range of Motion, Articular
Transplantation, Homologous

Figure

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  Fig. 1 72-year-old woman who undergone total knee arthroplasty in her left knee. (A) Preoperation radiography shows a septic loosening. (B) 1st stage operation with use of static spacers and antibiotic impregnated bone cement beads. (C) Large bone defect in the distal femur (Anderson Orthopaedic Research Institute classification, T1/F2A). (D) At 2 years 9 months follow-up, radiograph shows the host-graft incorporation.

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  Fig. 2 70-year-old woman who undergone total knee arthroplasty in her left knee. (A) Preoperative radiograph shows aseptic loosening & osteolysis. (B) Large bone defect in the both femur, tibia sites (Anderson Orthopaedic Research Institute classification, T2A/F3). (C) At distal femur, the strut allograft-implant composite. (D) At 3 years 4 months follow-up, radiograph after revision surgery shows the structural allograft fixed to the proximal portion of tibia, distal femur and the incorporation of the structural allograft to the host bone junction.

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  Fig. 3 The zonal analysis of radiolucent lines around femoral and tibial components.

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