Akakpo A, Dereudre G, Fouilleron N, Pasquier G, Migaud H. Poor short-term outcomes after computer-assisted rotating-platform total knee arthroplasty with a deep-trochlear-groove femoral component: analysis of 19 patients.
Orthop Traumatol Surg Res 2013;
99:183-90. [PMID:
23415824 DOI:
10.1016/j.otsr.2012.07.010]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2011] [Revised: 07/03/2012] [Accepted: 07/23/2012] [Indexed: 02/02/2023]
Abstract
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, 66.8 years; range, 58-82 years). 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 35.3 months. 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 24 months and 65% (51-78%) after 44 months.
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.
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