Poor short-term outcomes after computer-assisted rotating-platform total knee arthroplasty with a deep-trochlear-groove femoral component: Analysis of 19 patients - 30/03/13
, G. Dereudre a, b, N. Fouilleron a, b, G. Pasquier a, b, H. Migaud a, b
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Summary |
Background |
Congruent rotating tibial plateaus are designed to minimise wear after total knee arthroplasty (TKA). The Score™ prosthesis has a congruent rotating tibial plateau, a deep trochlear groove, and uses a computer-assisted navigation system for ligament balancing. Although this prosthesis is widely utilized, no accurate data on outcomes are available.
Hypothesis |
The innovative features of the Score™ prosthesis, most notably patellar replacement with a highly constrained femoral component, do not jeopardize implant survival.
Patients and methods |
In a pilot study, we retrospectively evaluated outcomes of 19 patients treated with Score™ knee replacement between February and October 2006 (mean age, 66.8years; range, 58–82years). The evaluation criteria were the International Knee Society (IKS) scores and prosthesis survival rate estimated using Kaplan-Meier plots with failure defined as revision need to change the prosthesis.
Results |
Mean follow-up was 35.3months. The IKS knee score increased from 27.4 (5–60) preoperatively to 81.4 (45–99) at last follow-up (P<0.0001). Mean mechanical axis was 181.2° (180–186°), with 16 between 180° and 183°. Revision surgery was required in five cases (for patellar complications with combined motion-range limitation in flexion (<90°) and extension (5–20°) in three cases, isolated motion-range limitation in one case, and recurvatum deformity with instability in one case). Prosthesis survival was 82% (73–91%) after 24months and 65% (51–78%) after 44months.
Discussion |
The deep trochlear groove femoral component resulted in patellar complications, which were the most common reasons for revision surgery, together with motion-range limitation and instability possibly related to improper use of the navigation system. This small retrospective case-series study showed an unusually low prosthesis survival rate probably related to the implant design. We no longer use the Score™ prosthesis, despite the availability of a dedicated navigation system, and we recommend careful monitoring of patients who have this prosthesis.
Level of evidence |
Level IV, retrospective study.
Le texte complet de cet article est disponible en PDF.Keywords : Knee prosthesis, Rotating platform, Computer-assisted implant surgery, Patello-femoral, Instability
Plan
Vol 99 - N° 2
P. 183-190 - avril 2013 Retour au numéro
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