期刊论文详细信息
Journal of Orthopaedic Surgery and Research
Improved knee flexion following high-flexion total knee arthroplasty
Li Fang1  Kathryn E Brewer1  Mitchell D Eggers1  David R Lionberger2 
[1] Foundation for Southwest Orthopedic Research, 6560 Fannin Street, Suite 1020, Houston, TX, 77030, USA;Southwest Orthopedic Group, L.L.P., 6560 Fannin Street, Suite 1016, Houston, TX, 77030, USA
关键词: Range of motion;    Body mass index;    Total knee arthroplasty;    Gender-specific high-flexion knee prosthesis;    Osteoarthritis;   
Others  :  817917
DOI  :  10.1186/1749-799X-7-22
 received in 2010-03-31, accepted in 2012-05-02,  发布年份 2012
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【 摘 要 】

Background

The application of new techniques and materials in total knee arthroplasty (TKA) continue to be a primary focus in orthopedic surgery. The primary aim of the present study is to evaluate post TKA total range of motion (ROM) among a group of patients who received a gender specific high-flexion design modification implant compared to a control group of patients who received non-gender specific implants.

Methods and results

The control group was comprised of 39 TKAs that were recruited pre-operatively and received the non-gender specific implant while the study group consisted of 39 TKAs who received gender specific implants. The study group yielded an improvement in mean post-operative ROM of 21° at 12 months, whereas the mean improvement in ROM among the control group was 11°. Thus, the study group had a 10° increased ROM improvement (91%) over the control group (p = 0.00060). In addition, 100% of the subjects with gender specific high-flexion implants achieved greater or equal ROM post-operatively compared to 82% for the control cohort. Lastly, women who exhibited greater pre-operative ROM and lower body mass index (BMI) were found to benefit the most with the gender specific prosthesis.

Conclusion

Our study demonstrates that among subjects with a normal BMI, the gender specific high-flexion knee implant is associated with increased ROM as compared to the non-gender specific non-high-flexion implant designs.

【 授权许可】

   
2012 Lionberger et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Krackow KA, Thomas SC, Jones LC: A new stitch for ligament-tendon fixation. Brief note. J Bone Joint Surg Am 1986, 68:764.
  • [2]Engh GA, Peterson TL: Comparative experience with intramedullary and extramedullary alignment in total knee arthroplasty. J Arthroplasty 1990, 5:1.
  • [3]Stern SH, Insall JN: Posterior stabilized prosthesis. Results after follow-up of nine to twelve years. J Bone Joint Surg Am 1992, 74:980.
  • [4]Hitt K, Shurman JR, Greene K, McCarthy J, Moskal J, Hoeman T, Mont MA: Anthropometric measurements of the human knee: correlation to the sizing of current knee arthroplasty systems. J Bone Joint Surg Am 2003, 85:115.
  • [5]Poilvache PL, Insall JN, Scuderi GR, Fond-Rodriguez DE: Rotational landmarks and sizing of the distal femur in total knee arthroplasty. Clin Orthop Relat Res 1996, 331:35.
  • [6]Aglietti P, Insall JN, Cerulli G: Patellar pain and incongruence. 1: Measurements of incongruence. Clin Orthop Relat Res 1983, 176:217.
  • [7]Woodland LH, Francis RS: Parameters and comparisons of the quadriceps angle of college-aged men and women in the supine and standing positions. Am J Sports Medicine 1992, 20(2):208.
  • [8]Amin AK, Clayton RAE, Patton JT, Cook RE: Total knee replacement in morbidly obese patients: Results of a prospective, matched study. J Bone Joint Surg 2006, Br 88:1321.
  • [9]Ritter MA, Eizember L, Keating EM, Faris PM: The influence of age and gender on the outcome of total knee arthroplasty. Todays OR Nurse 1995, 17:10.
  • [10]Ritter MA, Wing JT, Berend ME, et al.: The clinical effect of gender on outcome of total knee arthroplasty. J Arthroplasty 2008, 23(3):331.
  • [11]MacDonald SJ, Charron KD, Bourne RB, Bourne RB, Naudie DD, McCalden RW, Rorabeck CH: Gender-specific total knee replacement. Prospectively collected clinical outcomes. Clin Orthop Relat Res 2008, 466:2612.
  • [12]Dennis DA, Komistek RD, Stiehl JB, Walker SA, Dennis KN: Range of motion after total knee arthroplasty: the effect of implant design and weight-bearing conditions. J Arthroplasty 1998, 3:748.
  • [13]Anouchi YS, McShane M, Kelly F, Elting J, Stiehl J: Range of motion in total knee replacement. Clin Orthop 1996, 331:87.
  • [14]Wright J, Ewald FC, Walker PS, Thomas WH, Ross P, Sledge CB: Total knee arthroplasty with the kinematic prosthesis. Results after five to nine years: a follow-up note. J Bone Joint Surg Am 1990, 72:1003.
  • [15]Mulholland SJ, Wyss UP: Activities of daily living in non-Western cultures: range of motion requirements for hip and knee joint implants. Int J Rehabil Res 2001, 24:191.
  • [16]Insall JN, Dorr LD, Scott RD, Scott WN: Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 1989, 248:13.
  • [17]Liow RY, Walker K, Wajid MA, Bedi G, Lennox CM: The reliability of the American Knee Society Score. Acta Orthop Scand 2000, 71:603.
  • [18]Laskin RS: The effect of a high-flex implant on postoperative flexion after primary total knee arthroplasty. Orthopedics 2007, 30(suppl 8):86.
  • [19]Huang HT, Su JY, Wang GJ: The early results of high-flex total knee arthroplasty: a minimum of 2 years of follow-up. J Arthroplasty 2005, 20(5):674.
  • [20]Weeden SH, Schmidt R: A randomized, prospective study of primary total knee components designed for increased flexion. J Arthroplasty 2007, 22(3):349.
  • [21]Bin SI, Nam TS: Early results of high-flex total knee arthroplasty: comparison study at 1 year after surgery. Knee Surg Sports Traumatol Arthrosc 2006, 15:350.
  • [22]Suggs JF, Kwon YM, Durbhakula SM, Hanson GR, Li G: In vivo flexion and kinematics of the knee after TKA: comparison of a conventional and a high flexion cruciate-retaining TKA design. Knee Surg Sports Traumatol Arthrosc 2009, 17(2):150-153. [EPub ahead of print]
  • [23]Kim YH, Sohn KS, Kim JS: Range of motion of standard and high-flexion posterior stabilized total knee prosthesis. A prospective, randomized study. J Bone Joint Surg Am 2005, 87:1470.
  • [24]Seon JK, Song EK, Lee JY: Comparison of range of motion of high-flexion prosthesis and mobile-bearing prosthesis in total knee arthroplasty. Orthopedics 2005, 28:s1247.
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