Comparable Short-term Results Seen with Standard and High-flexion Knee Arthroplasty Designs in European Patients

Overview

Journal J Orthop

Specialty Orthopedics

Date 2014 Jan 8

PMID 24396227

Citations 4

Authors

Markus Fischer

Ruediger von Eisenhart-Rothe

Hans-Georg Simank

Affiliations

Soon will be listed here.

Abstract

Purpose: In a prospective study we evaluated outcomes of total knee arthroplasty (TKA) procedures in 62 patients with a follow up of 12 months to test our hypothesis that high-flexion CR (cruciate retaining) TKA provides a better range of motion and better outcome than standard CR design in Central European patients with their special problems and demands.

Methods: Patients were randomly divided into two groups (high flex vs. standard). The outcome was determined by measuring maximum knee flexion and using the KS-score and the SF-36 score.

Results: After 12 months ability to flex the knee significantly improved in both groups to 115° (SD 11) in the high flex group versus 119° (SD 12) in the standard group. There was no difference between the designs regarding maximum flexion (p = 0.78). Overall clinical rating scores significantly improved in both groups, but there was no difference between groups at one year after surgery (p (KSS) = 0.7 and p (SF-36) = 0.63). KS-score values improved from 25 points to 89 points for standard TKAs and from 20 points to 90 points for high flex TKAs. SF-36-score "Physical Functioning" values improved from 33 points to 66 points for standard TKAs and from 27 points to 63 points for high flex TKAs.

Conclusion: Our results confirm known good results of the procedure and suggest that the benefit of high flex knee designs is similar to standard knee designs one year after index surgery. Further studies are required to evaluate long-term results of both designs.

Citing Articles

Is high flexion total knee arthroplasty a rewarding procedure? An updated meta-analysis of prospective randomized controlled trials.

Lei T, Qian H, Hua L, de Abreu E Silva G, Hu Y, Lei P Arch Orthop Trauma Surg. 2020; 141(5):783-793.

PMID: 32448929 DOI: 10.1007/s00402-020-03481-9.

Do outcomes reported in randomised controlled trials of joint replacement surgery fulfil the OMERACT 2.0 Filter? A review of the 2008 and 2013 literature.

Wall P, Richards B, Sprowson A, Buchbinder R, Singh J Syst Rev. 2017; 6(1):106.

PMID: 28558822 PMC: 5450048. DOI: 10.1186/s13643-017-0498-3.

Simplified Chinese version of the Forgotten Joint Score (FJS) for patients who underwent joint arthroplasty: cross-cultural adaptation and validation.

Cao S, Liu N, Han W, Zi Y, Peng F, Li L J Orthop Surg Res. 2017; 12(1):6.

PMID: 28088227 PMC: 5237477. DOI: 10.1186/s13018-016-0508-5.

Does knee awareness differ between different knee arthroplasty prostheses? A matched, case-control, cross-sectional study.

Thomsen M, Latifi R, Kallemose T, Husted H, Troelsen A BMC Musculoskelet Disord. 2016; 17:141.

PMID: 27036995 PMC: 4818449. DOI: 10.1186/s12891-016-1001-3.

References

Argenson J, Komistek R, Mahfouz M, Walker S, Aubaniac J, Dennis D . A high flexion total knee arthroplasty design replicates healthy knee motion. Clin Orthop Relat Res. 2004; (428):174-9. DOI: 10.1097/01.blo.0000148948.79128.76. View

Massin P, Gournay A . Optimization of the posterior condylar offset, tibial slope, and condylar roll-back in total knee arthroplasty. J Arthroplasty. 2006; 21(6):889-96. DOI: 10.1016/j.arth.2005.10.019. View

Barink M, de Waal Malefijt M, Celada P, Vena P, van Kampen A, Verdonschot N . A mechanical comparison of high-flexion and conventional total knee arthroplasty. Proc Inst Mech Eng H. 2008; 222(3):297-307. DOI: 10.1243/09544119JEIM353. View

Tanavalee A, Ngarmukos S, Tantavisut S, Limtrakul A . High-flexion TKA in patients with a minimum of 120 degrees of pre-operative knee flexion: outcomes at six years of follow-up. Int Orthop. 2010; 35(9):1321-6. PMC: 3167458. DOI: 10.1007/s00264-010-1140-3. View

Jerosch J, Floren M . [Quality of life improvement (SF-36) after implantation of a knee endoprosthesis]. Unfallchirurg. 2000; 103(5):371-4. DOI: 10.1007/s001130050552. View

Insall J, Dorr L, Scott R, Scott W . Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989; (248):13-4. View

Malviya A, Lingard E, Weir D, Deehan D . Predicting range of movement after knee replacement: the importance of posterior condylar offset and tibial slope. Knee Surg Sports Traumatol Arthrosc. 2009; 17(5):491-8. DOI: 10.1007/s00167-008-0712-x. View

Ritter M, Harty L, Davis K, Meding J, Berend M . Predicting range of motion after total knee arthroplasty. Clustering, log-linear regression, and regression tree analysis. J Bone Joint Surg Am. 2003; 85(7):1278-85. DOI: 10.2106/00004623-200307000-00014. View

Han H, Kang S, Yoon K . High incidence of loosening of the femoral component in legacy posterior stabilised-flex total knee replacement. J Bone Joint Surg Br. 2007; 89(11):1457-61. DOI: 10.1302/0301-620X.89B11.19840. View

10.

Noble P, Gordon M, Weiss J, Reddix R, Conditt M, Mathis K . Does total knee replacement restore normal knee function?. Clin Orthop Relat Res. 2005; (431):157-65. DOI: 10.1097/01.blo.0000150130.03519.fb. View

11.

Wohlrab D, Hube R, Zeh A, Hein W . Clinical and radiological results of high flex total knee arthroplasty: a 5 year follow-up. Arch Orthop Trauma Surg. 2008; 129(1):21-4. DOI: 10.1007/s00402-008-0665-z. View

12.

Sumino T, Gadikota H, Varadarajan K, Kwon Y, Rubash H, Li G . Do high flexion posterior stabilised total knee arthroplasty designs increase knee flexion? A meta analysis. Int Orthop. 2011; 35(9):1309-19. PMC: 3167449. DOI: 10.1007/s00264-011-1228-4. View

13.

Bellemans J, Banks S, Victor J, Vandenneucker H, Moemans A . Fluoroscopic analysis of the kinematics of deep flexion in total knee arthroplasty. Influence of posterior condylar offset. J Bone Joint Surg Br. 2002; 84(1):50-3. DOI: 10.1302/0301-620x.84b1.12432. View

14.

Huang H, Su J, Wang G . The early results of high-flex total knee arthroplasty: a minimum of 2 years of follow-up. J Arthroplasty. 2005; 20(5):674-9. DOI: 10.1016/j.arth.2004.09.053. View

15.

Minoda Y, Aihara M, Sakawa A, Fukuoka S, Hayakawa K, Ohzono K . Range of motion of standard and high-flexion cruciate retaining total knee prostheses. J Arthroplasty. 2008; 24(5):674-80. DOI: 10.1016/j.arth.2008.02.015. View