Objective: To investigate results of total knee arthroplasty using the long-stem tibial component combined with metallic wedge of knee prosthesis for the treatment of proximal defects.
Methods: From January 2011 to May 2013, 10 patients (11 knees) were treated with total knee arthroplasties using the long-stem tibial component with metallic tibial wedge of knee prosthesis. All the patients were female and the average age was 67 years old (ranged, 60 to 77 years old). All the patients were osteoarthritis. All the patients were classified as T2A style. The patients were evaluated according to knee score system (KSS).
Results: All the patients were followed up for 12 months on average (ranged 3 to 29 months). The clinical outcome was assessed using KSS score, including knee pain score, knee stability score, knee range of motion score and knee walking score, knee stairs score. There were significantly differences at 6 weeks, 3 months, 6 months and 12 months between pre-and postoperative KSS score.
Conclusion: The mechanical stability of tibial fixation in primary TKA is significantly increased by using the long-stem tibial component with metallic wedge of knee prosthesis, even in the presence of poor proximal bone.
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Cureus
August 2024
Orthopaedics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Constrained implants have become more common in difficult primary total knee arthroplasty (TKA) cases in recent years because they may more effectively and conveniently handle the substantial instability that is evident in osteoarthritis of knees with severe varus deformity. However, the need for a constrained TKA in such conditions is controversial, as constraint implants come with a bargain of stability for longitivity. In this case report, we have successfully shown that even in cases of significant instability and bone loss, intraoperative conversion to a restricted device is rarely necessary.
View Article and Find Full Text PDFCureus
May 2024
Orthopedic Surgery, King Fahad Military Medical Complex, Dhahran, SAU.
Total knee arthroplasty (TKA) aims to alleviate severe pain and functional impairment in advanced knee arthritis. However, extra-articular deformities must be addressed preoperatively to ensure optimal implant positioning and soft tissue balancing. We present a case of a 58-year-old man with a history of a right tibial malunion and left femoral shaft fracture, who developed progressive bilateral knee osteoarthritis.
View Article and Find Full Text PDFJ Knee Surg
November 2024
Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
The aim of this study was to investigate the biomechanical effects of stem extension with a medial tibial bone defect in primary total knee arthroplasty (TKA) on load distribution and stress in the proximal tibia using finite element (FE) analysis.FE simulations were performed on the tibia bone to evaluate the stress and strain on the tibia bone and bone cement. This was done to investigate the stress shielding effect, stability of the tibia plate, and the biomechanical effects in TKA models with various medial defects and different stem length models.
View Article and Find Full Text PDFJ Knee Surg
September 2024
Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
Printed porous titanium metaphyseal cones have become a mainstay for managing bone loss in revision total knee arthroplasty (rTKA). A short or long stem is routinely used when implanting a cone to augment fixation and offload stresses. This retrospective analysis compared the short-term survivorships and functional outcomes for use of a short or long stem with a metaphyseal cone.
View Article and Find Full Text PDFJ Arthroplasty
August 2024
Department of Orthopedic Surgery, Institute for Locomotion, Aix-Marseille University, Marseille, France; Department of Biomechanics, Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Marseille, France.
Background: Obesity can be a source of higher failure rates and inferior clinical outcomes after total knee arthroplasty (TKA). The aim of this study was to compare outcomes, failure rates, and stress distributions of TKA in obese patients using a short, long, or no tibial stem.
Methods: A matching process based on the type of stem used and the age allowed included 180 patients who had a body mass index (BMI) > 30 and underwent a TKA between January 2010 and December 2019, with a minimum follow-up of 2 years.
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