Abstract
Ethnic cultural demands of the patient have encouraged surgeons to use high-flexion
designs. It has been speculated that these high-flexion designs may produce higher
incidence of patellofemoral complications over conventional designs. We wish to report
5- to 7-year follow-up of this design with special emphasis on patellofemoral outcomes.
We performed a prospective study involving 159 patients who underwent computer-assisted
simultaneous bilateral total knee arthroplasty (TKA) with high-flexion design. Patients
were evaluated clinically using Knee Society score (KSS), Western Ontario and McMaster
University Osteoarthritis (WOMAC) score, and Hospital for Special Surgery patella
score with a minimum follow-up period of 5 years. At last follow-up, mean scores were
KSS (88.7), WOMAC (48.5), and HSS (86.7). All the scores improved postoperatively.
Average preoperative range of motion was 108 degrees, which improved to 132 degrees
postoperatively. There was no evidence of loosening or spin out in our study. Our
study shows that TKA done using high-flexion rotating platform design results in near
normal patellofemoral tracking patterns with improvement in function. The level of
evidence of the study is IV.
Keywords
patellofemoral complications - high-flexion design - total knee arthroplasty
