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J Knee Surg 2018; 31(02): 197-201
DOI: 10.1055/s-0037-1603337
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Revision Total Knee Arthroplasty Using a Constrained Condylar Knee Prosthesis Combined with a Posterior Stabilized Articular Surface

Shang-Wen Tsai
1   Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
2   Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
,
Cheng-Fong Chen
1   Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
2   Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
,
Po-Kuei Wu
1   Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
2   Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
3   Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
,
Chao-Ming Chen
2   Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
3   Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
4   Rehabilitation and Technical Aid Center, Taipei Veterans General Hospital, Taipei, Taiwan
,
Wei-Ming Chen
1   Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
2   Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
4   Rehabilitation and Technical Aid Center, Taipei Veterans General Hospital, Taipei, Taiwan
› Author Affiliations
Further Information

Publication History

01 February 2017

31 March 2017

Publication Date:
23 May 2017 (online)

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Abstract

Intraoperative assessment of valgus–varus stability is crucial for choosing articular surfaces with different levels of constraint. Legacy constrained condylar knee (CCK) prostheses are readily available to assemble and use with a CCK articular surface or a posterior stabilized (PS) articular surface in revision knee arthroplasty surgeries. We wanted to validate outcomes of revision total knee arthroplasty (TKA) using legacy CCK prostheses combined with a PS articular surface. Thirty-seven patients were enrolled and followed up for more than 2 years. Range of motion (ROM), the Knee Society score (KSS), the Knee Society functional score (KSS-F), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were used to evaluate outcomes. Follow-up was a mean of 86.5 months (range: 28–152 months). The mean age of the participants was 69.8 years (range: 31–86 years). The mean ROM was 110.5 degrees, the KSS was 86.2 points, the KSS-F was 68.3 points, and the WOMAC score was 22.6 points. Seven participants had implant failures: five because of delayed infections and two because of posterior dislocations. In conclusion, revision TKA using a CCK prosthesis combined with a PS articular surface might provide satisfactory mid-term outcomes. Delayed infection was the most common cause of implant failure. Dislocation might occur in middle-old or older patients despite careful intraoperative examination of valgus–varus stability, extension–flexion gap balancing, and signs of recurvatum.

Keywords

articular surface - constrained condylar knee - inserted - posterior stabilized - revision total knee arthroplasty
 

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