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At least 325 records · Page 18Linked to original sources
PubMed1995

Insall-Burstein posterior-stabilized knee prosthesis in rheumatoid arthritis.

The authors reviewed 65 Insall-Burstein (Zimmer, Warsaw, IN) total condylar posterior-stabilized knee prostheses in 50 patients with rheumatoid arthritis with a follow-up period of at least 5 years (range, 5-13 years). Forty-two knees in 31 patients were evaluated using the Knee Society knee and functional rating scores. Radiographic assessment was performed using standing long radiographs (hip to ankle). Radiolucent lines were studied using fluoroscopic-centered views. Excellent or good clinical results were obtained in 95% of the cases, and the average knee score improved from 22.5 to 90 points. No cases of radiologic loosening were observed. Incomplete radiolucent lines around the tibial component were detected in only 17% and were nonprogressive. Two patients developed hematogenous late deep infection, which required removal of the prosthesis in both, followed, at a second stage, by arthrodesis in one and prosthesis reimplantation in the other. Three knees (7%) had a painful impingement of the patella. Two of these were successfully reoperated with arthroscopic debridement of the peripatellar synovial tissues. Survivorship analysis, based on endpoints such as prosthesis removal for any cause or radiologic loosening (complete radiolucent line thicker than 1 mm, tilt, or subsidence of the component), showed a cumulative success rate of 96.2% at 13 years.

Arthritis, Rheumatoid↗
PubMed1986

St Georg modular knee prosthesis. A two-and-a-half to six-year follow-up.

The St Georg modular knee replacement has been studied in 59 cases with an observation period ranging from 28 to 73 months. In 47% of the knees both compartments were replaced; five of the six poor results were in this group. These were revised to a hinge arthroplasty or, in one case, to an arthrodesis. Other complications were few and insignificant. There were no infections. We concluded that unicompartmental knee arthroplasty can be recommended when joint involvement is localised to one compartment only. With more generalised joint disease we prefer a semiconstrained total condylar prosthesis.

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PubMed2000

[Results of arthrodesis after knee prosthesis infection. Special reference to quality of life].

AIM OF THE STUDY: In case of extensive bone loss arthrodesis can be more favourable than one or two stage revisions with new arthroplasties after infected implants. MATERIAL AND METHODS: 19 patients with arthrodesis of the knee joint because of infected arthroplasty were clinical-radiological examined after 5.2 years. The quality of life was measured with the SF-36 score. The average age at the arthroplasty implantation was 63.8 years. 5 patients had constrained prostheses, 14 bicondylar sledge prostheses. DISCUSSION: The average results in health orientated life quality of patients with arthrodesis in case of infected arthroplasty were lower than in control groups but singular aspects scored higher. After the arthrodesis some patients increased their levels compared to the period with arthroplasty. CLINICAL RELEVANCE: The fear of loss of quality after arthrodesis of the knee joint can not be supported. Some results were not better with arthroplasty or without an operation.

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PubMed1991

[The AGC 2000 knee prosthesis: observations on the first 35 cases].

The authors state the indications and report the results of their first 35 consecutive AGC total knee arthroplasties. Both the characteristic of the prosthesis and the modalities of the application technique are analyzed. The results are evaluated from a clinical and radiographic point of view.

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PubMed1979

Initial experiences with a total knee prosthesis implanted without bone cement.

Prosthetic loosening and stem fractures have been the most frequently encountered complications of knee arthroplasties using the Guepar Hinged prothesis. The insufficient intramedullary fixation of the stem and the use of cement in the femur and tibia are primarily responsible for these complications. In our clinic, we have used an altered Guepar Hinged prothesis since 1975. The femoral and tibial stems are lengthened with medullary nails, resulting in stems with high bending and torsional stress capacities. The fixation strength of these special long stems in the medullary cavities is such that we no longer use cement for this prosthesis. The initial results of our cementless implantation of these special long-stem knee prostheses, and the advantages of this method are reported.

Arthritis↗
PubMed1984

Load-bearing capacity of the tibial component of the total condylar knee prosthesis. An in vitro study.

The load-bearing capability of the tibial component of total knee prostheses is affected by the coverage of the osteotomized tibial surface by the tibial component. An anthropometric study of the proximal tibia indicated that standard total condylar tibial knee components may significantly underutilize the available weight-bearing tibial surface. The unloaded area values ranged from 6% to 43% in males and from 1% to 25% in females. An experimental study of the load-bearing capability of both standard tibial components and tibial components custom-fitted to conform to the periphery of the upper tibial surface was performed. Improvement in single load to failure with the conforming prosthesis averaged 29% in females with stemless prosthesis, 21% in females with stemmed prostheses, 41% in males with stemless prostheses, and 89% in males with stemmed prostheses. Post-test examination of the failed tibiae with conforming implants indicated failure by major fragmenting of the proximal tibia rather than cancellous bone crushing, suggesting that the maximal load-bearing ability of the upper tibial surface was more nearly being achieved. The results demonstrate the benefit to be gained by fully utilizing the available tibial surface for load transmission across the joint and suggest that use of custom-fitted tibial components has considerable merit.

Anthropometry↗
PubMed2003

Long-term results of a cementless knee prosthesis with a metal-backed patellar component: clinical and radiological follow-up with histology from retrieved components.

Aseptic loosening of cemented knee arthroplasties has encouraged development of uncemented fixation. The Miller-Galante I (MG I) prosthesis was designed to achieve permanent stability through ingrowth into a titanium fiber mesh. Thirty-five knees in 30 patients with MG I knee replacements have been followed clinically and radiologically with a mean follow-up of 12 years. Twenty knees were revised with a mean follow-up of 5 years. Patellofemoral problems, especially avulsion of the polyethylene from the metal-backed patella and in some cases severe metallosis, have been the main reason for revision. Metal-backed patellar component should be avoided. In addition, instability has been a problem. However, the fixation of the components has been excellent, with a high degree of osseous ingrowth displayed at histological analysis of retrieved components. The clinical and radiological results after revision are in most cases good, despite the femoral component having been left in situ.

Arthroplasty, Replacement, Knee↗
PubMed2000

[Osteolysis after total knee prosthesis].

PURPOSE OF THE STUDY: The aim of our work was to study X-rays showing osteolysis after 5 years and more in 122 prosthesis and to try and assess such complication, often described in the United States but seldom in Europ. MATERIAL: We are dealing here with 122 retaining posterior cruciate ligament, mostly cementless prothesis implanted between 1985 and 1992 84 chromium-cobalt prosthesis (PCA and Themis) implanted in 34 males and 88 females with an average age of 67 (45-81), 87,7 p. 100 had femoral cementless components and 70 p. 100 tibial cementless components. METHODS: All patients were examined and had X-rays at an average of 6,9 years. Specially considered were X-rays showing a possible osteolysis. We looked for possible complication (external laxity, anterior femoral dislocation and polyethylene wear), assessment of the mechanical axis and for clinical results (Hungerford score) RESULTS: Revisions: 19 arthroplasties were revised for PE wear tibial loosening metallosis or patella problems The postoperative score according to Hungerford was 84,5 p. 100 for PCA prosthese and 87 p.100 for the Themis. On the X-rays were only few osteolysis to be found: 9 cases (7,3 p. 100). For the PCA series: 3 femoral osteolysis, 1 tibial at 12 years, and one patellar osteolysis. For the Themis series: no femoral osteolysis, 3 tibial and one patellar osteolysis. Osteolysis are apparent on X-rays in profile for the femur and the patella, and in both profile and frontal X-rays for the tibia. Clinicaly 4 osteolysis really asymptomatic were not re-operated. 5 were revised: one 11 years later for femoral and tibial loosening, two for a patellar loosening, the other two patients had to be reoperated on for metallism (titanium's femoral component) and for those two instances osteolysis were discovered during the complication. DISCUSSION: Osteolysis after TKA appears unusual in our experience without bearing on frequency finded by american authors with a lesser follow-up (Engh 11,1 p. 100 after 4,5y, Peters 16 p. 100 after 2,9 y, Robinson 9,18 p. 100 after 4,6 y). American litteratur analysis shows that the important number of osteolysis is due to: - either to dual-metal using (Co-Cr component with Titanium screws for exemple), - or bad quality of polyethylene (compressed), - or a bad design of former prosthesis. CONCLUSION: Interface illness, linked to the production of wear debris, osteolysis after total knee arthroplasty is rarer than after a hip one, probably because size of debris is different, larger in knee than in hip. It is likely that the improvement of PE quality, design of prosthesis, as well as a better knowledge of osteolysis mechanism will allow to delay this complication wich is in a long term ineluctable.

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