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At least 235 records · Page 13Linked to original sources
PubMed1999

[Mobility of a polyethylene tibial insert in a mobile total knee prosthesis].

PURPOSE: We have studied the mobility of a mobile tibial implant in total knee arthroplasty (TKA) by a radiographical evaluation. MATERIAL AND METHODS: We analyzed mobility of the polyethylene tibial insert of 15 "G2S" TKA implanted for one year or more. We established a dynamic radiographical evaluation. We used 3 weight-bearing radiographs: AP in extension and two lateral (one in extension and one at 90 degrees of flexion), two AP with femoral internal and external rotation, 2 strict lateral X-rays in neutral rotation in antero-posterior replacement with a 25 kilograms strength Telos, and 2 AP in varus and valgus with Telos. Wilcoxon's test and Fisher's exact test were used for statistical evaluation. RESULTS: Our study demonstrated preservation of the polyethylene mobility in tibial TKA implant in all movements: in rotation, in antero-posterior translation with Telos, and even in antero-posterior translation during physiological condition with flexion-extension weight-bearing radiographs. Statistical tests were very significant. We noticed that flexion induced anterior translation of tibial polyethylene when PCL was preserved. CONCLUSION: This study answered to our question whether mobility of TKA tibial implant persists after implantation. This mobility should reduce loosening forces to the tibia and stress in the polyethylene component. Now we have to determine the amplitude of mobility required to reach this objective.

Arthroplasty, Replacement, Knee↗
PubMed1996

[Results of early rehabilitation using various knee prosthesis models].

The present contribution deals with the early rehabilitation outcomes achieved using total knee arthroplasties with major differences in design. Hinged and unhinged total knee replacements are compared for a total of 100 patients included in the prospective study (48 hinged prostheses, and 52 unhinged ones). Evaluation of the functional and subjective parameters included shows that major improvements in total scores had been achieved in both groups already after 5 weeks, even more pronounced after 10 weeks. With a number of differences found for the various criteria assessed, it in particular is the fact of early stability of the joint in using the hinged prostheses that entails speedy progress and a good rehabilitation outcome. Due consideration of the different early outcomes for the various parameters, hence, is imperative in pre-operative decision-making.

Activities of Daily Living↗
PubMed2004

Comparison of a mobile with a fixed tibial bearing unicompartimental knee prosthesis: a prospective randomized trial using a dedicated outcome score.

Between February 1996 and December 1997, forty consecutive patients with medial compartment knee arthritis were assigned randomly into two groups. All underwent a unicompartimental knee replacement. The tibial prosthesis in group A (20 knees) had a fixed bearing and in group B (20 knees) a mobile bearing. The average age was 69. Five in group A and 71 in group B. Pre-operatively, and at an average follow-up of 5.7 years, all the knees were assessed using both a dedicated UKR score specifically developed and adopted by the Italian Orthopaedic Unicompartimental Knee Replacement Users Group (GIUM) and the Knee Society Score. During surgery in group B we experienced a medial tibial plateau fracture fixed intra-operatively. One prosthesis in group A required an early revision to a TKR because of a continuous pain without any evident sign of loosening. There were no meniscal dislocations in group B. No statistically significant difference in outcome was observed between the two groups at the latest follow-up.

Aged↗
PubMed1981

The GSB knee prosthesis.

In the three years' period 1976-1978, 53 GSB knee prostheses were inserted in 46 patients. The use of this type of prosthesis was mainly indicated for the relief of pain in the presence of severe deformity or ligamentous insufficiency. There were two subsequent arthrodeses, one for infection and one for persistent pain. A follow-up study of 39 prostheses (excluding the two arthrodeses) revealed relief or reduction of pain to an acceptable level in 35 of the 39 knees (90%). The patients, however, were enthusiastic or satisfied with 37 of the 39 knee prostheses available for follow-up (05%). Good alignment and movement were obtained in all knees except one, in which flexion was less than 60 degrees. The most frequent problem was mild to moderate patello-femoral pain in 12 (31%) of the 39 knee-arthroplasties. This can largely be avoided if taken into account when planning the operation.

Follow-Up Studies↗
PubMedDate not supplied

[Aseptic arthritis after total knee prosthesis].

In 3 patients who developed acute arthritis of the knee 3 months to 5 years after insertion of a total condylar prosthesis, it was possible to formally exclude an infectious cause. A number of cytological and histological arguments confirm that these were cases of foreign body arthritis (polyethylene debris and metal dust). These cases of arthritis responded to local steroid treatment combined with a Yttrium synoviorthesis, in the absence of any antibiotic treatment. The synoviorthesis was performed in order to eliminate the real foreign body granuloma which develops and which can contribute to the loosening of these prostheses.

Adult↗
PubMed1978

The Liverpool Mark II knee prosthesis. A preliminary report.

This is a preliminary report of the results of knee joint replacements using the Liverpool Mark II knee joint system which consists of a bicondylar prosthesis and a set of stereotactic instruments. The prosthesis has been developed from Gunston's concept, and the special instruments ensure its accurate insertion through meniscectomy-type incisions placed on either side of the patella. Particular features of the prosthesis are near-normal articulation, and the simplicity of the operation. Sixty-two knee replacements were implanted in forty-two patients between the spring of 1974 and January 1977. After the operation fifty-six knees were painless and four others produced only slight pain. Full extension was obtained in fifty-eight knees, and none showed a valgus or varus deformity. Collateral laxity was absent in all knees. There were two failures. These early results are most encouraging.

Adult↗
PubMed1985

St. Georg hinged-knee prosthesis. A 2.5- to 8-year follow-up.

Thirty-eight St. Georgs hinged-knee arthroplasties were studied with a follow-up of 2.5-8 years; 86.8% of the patients obtained an excellent or a good result, and 7.9% of the arthroplasties were failures. There was an infection rate of 3.8% and 3.8% loose prostheses. Among the failures there were two infected arthroplasties. One was arthrodesed, resulting in a pseudoarthrosis and one was successfully revised. One traumatic loosening lead to arthrodesis. It is concluded that hinged-knee arthroplasty under special circumstances may be a useful procedure.

Adult↗
PubMed1993

[Modular cemented knee prosthesis Kinemax--is manual mobilization during extended contraction justified?].

Early results of 12 total Kinemax knee replacements have been presented. Maximal active flexion has been recorded on 8th, 15th day and half a year after operation. Standard rehabilitation of the operated joint has been conducted. No manual mobilisation was employed despite of the only one case of knee flexion close to 90 degrees 2 weeks after surgery. Half a year later flexion has reached or exceeded the right angle in all cases.

Adult↗
PubMed1997

In vivo kinematic analysis of a mobile bearing total knee prosthesis.

Ten normal subjects and 10 patients with a posterior cruciate retaining mobile bearing total knee replacement performed successive deep knee bends under fluoroscopy to determine tibiofemoral contact positions. At full extension the average initial contact position for the normal and mobile total knee replacement was 6.2 mm (range, 4.8 to 12 mm) anterior, and -4.4 mm (range, 3.9 to 11 mm) posterior to the sagittal tibial midplane, respectively. At 60 degrees flexion, the normal knee rolled back to -5.8 mm (range, -2.5 to -13.2 mm), whereas the mobile bearing total knee replacement rolled back to -9.2 mm (range, -4 to -17 mm). From 60 degrees to 90 degrees, normal knees rolled back to -7.8 mm (range, -5.8 to -13.8 mm), but the mobile bearing total knee replacement slid anteriorly to -5 mm (range, 2 to -12 mm). All mobile bearing total knee replacements had some form of roll back, but some slid anterior more than others. Five of 10 mobile bearing total knee replacements had some movement of the bearings while the others remained fixed. Patellar kinematics was similar to normal but reflected tibiofemoral abnormalities.

Arthroplasty, Replacement, Knee↗
PubMed1998

[The total knee prosthesis: indications and complications].

Severe pain, impaired movement, serious deformity and (or) instability of the knee due to osteoarthritis or another joint disease are indications for total knee replacement. Contraindications are a high surgical risk and poor function of the M. quadriceps femoris. The main problems immediately after the operation are: wound infection and prosthetic infection, palsy of the peroneal nerve and deep venous thrombosis. These occur in approximately 2% of the patients. After replacement and 3 months' rehabilitation the knee is usually free of pain and stable with a good range of movement. After 10 years, 93-98% of the operated knees are still satisfactory, and after 15 years, 85-95%. Reasons for revision are infection, mechanical loosening of components, wear of polyethylene and progressive instability.

Antibiotic Prophylaxis↗
PubMed1994

The total condylar knee prosthesis in osteoarthritis. A 5- to 10-year follow-up.

In 124 patients with osteoarthritis 152 knee arthroplasties were evaluated with a mean follow-up of 7 years (range 5.2-9.1 years). Forty-six patients (53 knees) were either dead or otherwise lost to follow-up. Thus, 99 knee arthroplasties were evaluated. Three arthroplasties had been revised. Of the remaining 96 knee arthroplasties, 95% had achieved a satisfactory result. Five arthroplasties were unacceptable. One had a poor result and four a fair result. The reason for the poor/fair results was in one case a loose patellar component and in one case malposition of the components and ligament insufficiency. In 54.2% of the arthroplasties, there were radiolucent lines beneath the tibial component. There was one fatal pulmonary embolism, and four knees with superficial wound infection. One of these probably went on to late loosening. There was one case of peroneal nerve palsy. Three cases of deep vein thrombosis were diagnosed.

Adult↗
PubMed2000

The AGC total knee prosthesis at average 11 years.

A retrospective study of a series of 126 consecutive primary cemented total knee replacements using the AGC prosthesis is reported. Sixty-two knees were available for long-term review with an average clinical follow-up of 11.4 years (range, 8.4-13.6 years). The survivorship was 95%, defining the endpoint as revision of all components for any reason except sepsis. The average knee flexion was 110.9 degrees. The average Knee Society score was 91, and the average Knee Society Functional score was 67. There was no finding of tibial polyethylene failure, wear debris-generated osteolysis, or tibial or femoral loosening. Seven metal-backed patellae developed wear-through at an average of 80.4 months (7 of 126 for a 5.5% failure rate), with 3 (2.3%) resulting in complete revision. The authors continue to use the AGC prosthesis with an all-polyethylene patella. Compared with historical controls, the AGC has comparable survivorship.

Biomechanical Phenomena↗