Introduction: Substantial flexion after total knee arthroplasty (TKA) is required for certain categories of patients who wish to squat or kneel in their daily life. Many factors influence this postoperative flexion, including the prosthesis design. It is therefore valuable to in vivo analyze these factors on three knee prosthesis designs through a study of their intraoperative flexion.
Hypothesis: The posterior-stabilized (PS) knee prostheses provide better intraoperative flexion than the ultracongruent (UC) model. Of the currently available PS models, the high-flexion ones have better intraoperative flexion than standard models. Our main focus endpoint was the intraoperative flexion achieved, before soft-tissues closure, during TKA surgical procedure.
Patients And Methods: This was a controlled study. Seventy-two osteoarthritic knees requiring TKA were included to compare three selected prosthesis models: the SAL ultracongruent and two PS models (the standard LPS and the LPS Flex). This was a single-operator study, with patients divided into three homogenous, comparable groups, in which intraoperative measurement of flexion was performed using computer-assisted navigation. Statistical analysis allowed comparison of the three models.
Results: Intraoperatively, after prosthesis implantation, before soft-tissues closure, the mean flexion of the LPS-Flex was 134 degrees versus 124 degrees for the SAL (p=0.0004); the mean flexion of the standard LPS model was 130 degrees versus 124 degrees for the SAL (p=0.14); the PS Flex model showed no significant difference (p=0.26) in flexion (134 degrees) compared to the standard model (130 degrees). The SAL ultracongruent model seemed to be a factor reducing the intraoperative flexion by 8 degrees compared to the PS models (p<10(-4)).
Discussion: In this study, the PS designs (standard or Flex) provided better intraoperative flexion than the SAL ultracongruent design. However, the LPS Prosthesis did not demonstrate superiority over the standard LPS Prosthesis.
Level Of Evidence: Level III, low-power prospective study.
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http://dx.doi.org/10.1016/j.otsr.2009.12.006 | DOI Listing |
JSES Int
November 2024
Department of Orthopaedic Surgery & Rehabilitation, Loyola Medicine, Maywood, IL, USA.
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November 2024
Division of Hand and Upper-Extremity Surgery, Department of Orthopaedic Surgery, Geisinger Commonwealth School of Medicine, Geisinger MSKI, Danville, PA, USA.
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January 2025
Department of Orthopaedic Surgery, Joint Replacement Unit, Kuala Lumpur Hospital, Ministry of Health Malaysia, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
Introduction: Extraarticular deformity (EAD) with knee arthritis is a complex condition involving tri-planar bone deformity with pathological malalignment and chronic soft tissue contracture or laxity in the knee joint. Intraarticular correction by TKA, which was previously performed with conventional manual jig by mechanical alignment technique, had its limits and difficulties especially extensive soft tissue release and risk of jeopardizing the collateral ligaments. Robotic technology allows for reproducible and precise execution of surgical plan and allows adjustment to various new personalised alignment philosophy including functional alignment (FA).
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July 2025
Department of Orthopaedic Surgery, Rush University Medical Center, Il, USA.
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J Orthop Case Rep
January 2025
Department of Orthopaedics, Dr. KNS Memorial Institute of Medical Sciences, Barabanki, Uttar Pradesh, India.
Introduction: Post-traumatic arthritis of elbow is a crippling condition that frequently develops after a serious joint injury. The condition is characterized by pain, rigidity, and diminished functionality, considerably affecting the quality of life of those impacted. Despite advancements in surgical and conservative management, the optimal treatment strategy remains elusive.
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