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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2012 December;63(6):447-53
Cemented, posterior stabilized, fixed bearing total knee arthroplasties: long term follow-up of 135 implants
Dolfin M. 1, Ravera L. 2, Deledda D. 2, Giordano A. 2, Drocco L. 3, Lagalla F. 3, Crova M. 3
1 Department of Orthopedics and Traumatology, S. Giovanni Bosco Hospital, Turin, Italy;
2 University of Turin, Turin, Italy;
3 Department of Orthopedics and Traumatology, 2nd Orthopedic Clinic, M. Adelaide Thraumatic Center, Turin, Italy
AIM:Total knee arthroplasty (TKA) is the gold standard in the treatment of knee arthritis, with excellent results in short- and long-term evaluation. Concerns remain about the method of fixation, the use of mobile tibial plateau, the sacrifice of the posterior cruciate ligament (PCL) and the patellar resurfacing. This prospective study analyses a series of 135 TKAs (117 patients), cemented fixed bearing, posterior stabilized and selective patellar resurfacing in non-selected patients implanted from 1998 to 2000.
METHODS: The Hospital for Special Surgery Scoring System (HSS) was used for the clinical evaluation and the Roentgenographic Evaluation Score was used for the radiographic study.
RESULTS: The survivorship of the implants decreased after the first years, but at over than 10 year follow-up was still 96,8. All items of the HSS improved. Total score improved from 54.2±7.42 SD to 84.83±6.91 SD, pains score from 6.26 (moderate) to 12.03 (absent or mild). Radiographs showed mobilization of the implant in three cases.
CONCLUSION:The results with this kind of implant are good, thus supporting the use of cement and the sacrifice of the PCL and the use of a fixed tibial plateau. Differences between resurfacing or not the patella have not been found. The tibial polyethylene insert has neither worn nor broken at 12 years.