Joint Line Changes and Outcomes in Constrained Versus Unconstrained Total Knee Arthroplasty for the Type II Valgus Knee

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2013 Jan 17

PMID 23322268

Citations 20

Authors

Hee-Nee Pang

Seng-Jin Yeo

Hwei-Chi Chong

Pak-Lin Chin

Shi-Lu Chia

Ngai-Nung Lo

Affiliations

Soon will be listed here.

Abstract

Purpose: The objective of this study was to compare the outcome of constrained and unconstrained primary total knee arthroplasty (TKA) in the management of the valgus deformity.

Methods: This is a retrospective review of patients with type II valgus knee who underwent primary TKA from 1999 to 2011. There were fifty patients in Group 1 who underwent varus-valgus constrained TKA. They were matched with another fifty patients in Group 2 who underwent unconstrained TKA.

Results: The mean joint line shift was significantly higher in Group 1 (+8 mm, SD 6 mm) than in Group 2 (+2 mm, SD 3 mm) (p = 0.03). At 2 years, there was no difference in anterior-posterior stability and mediolateral stability according to the Knee Society Score, and patients in Group 2 reported significantly better mean function score of 66.2 (SD 9.3) (mean 48, SD 7.1 in Group 1) (p = 0.002). Two patients (6 %) in Group 1 underwent revision surgery--one for a broken central peg and the other for aseptic loosening. Three patients (2 %) in Group 2 underwent revision surgery--two for global instability and one for poly wear. The estimated survivorship time was 8.3 years for constrained TKA and 12.0 for unconstrained TKA.

Conclusion: Constrained TKA was associated with more significant joint line changes for the management of valgus arthritic knee, when compared with unconstrained TKA.

Level Of Evidence: Retrospective study, Level III.

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