J 2021

Dlouhodobé výsledky totální náhrady kolenního kloubu P.F.C. Sigma s celopolyetylenovou tibiální komponentou

NACHTNEBL, Luboš, Tomáš TOMÁŠ, Vasileios APOSTOLOPOULOS, Lukáš PAZOUREK, Michal MAHDAL et. al.

Basic information

Original name

Dlouhodobé výsledky totální náhrady kolenního kloubu P.F.C. Sigma s celopolyetylenovou tibiální komponentou

Name (in English)

Long-Term Results of Total Knee Replacement Using P.F.C. Sigma System with an All-Polyethylene Tibial Component

Authors

NACHTNEBL, Luboš (203 Czech Republic, guarantor, belonging to the institution), Tomáš TOMÁŠ (203 Czech Republic, belonging to the institution), Vasileios APOSTOLOPOULOS (203 Czech Republic, belonging to the institution), Lukáš PAZOUREK (203 Czech Republic, belonging to the institution) and Michal MAHDAL (203 Czech Republic, belonging to the institution)

Edition

Acta chirurgiae orthopaedicae et traumatologiae čechoslovaca, Praha, Galén, 2021, 0001-5415

Other information

Language

Czech

Type of outcome

Článek v odborném periodiku

Field of Study

30211 Orthopaedics

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 0.222

RIV identification code

RIV/00216224:14110/21:00127177

Organization unit

Faculty of Medicine

UT WoS

000798817200002

Keywords in English

total knee replacement; all-polyethylene tibial component; long-term results

Tags

International impact, Reviewed
Změněno: 3/4/2023 12:13, Mgr. Tereza Miškechová

Abstract

ORIG EN

V originále

PURPOSE OF THE STUDY Use of an all-polyethylene (all-poly, AP) tibial component in primary total knee arthroplasty is still an attractive option considering the durability of replacement, the elimination of backside wear and the lower cost compared to modular metalbacked tibia. The purpose of the study was to evaluate the long-term results of the total knee replacement using the P.F.C. Sigma system with a monoblock all-polyethylene tibial component implanted at the 1st Orthopedic Department of the St. Anne's University Hospital and Masaryk University Brno in the period 1999-2010. MATERIAL AND METHODS In the monitored period, 911 total knee replacements using P.F.C. Sigma with an all-polyethylene tibial component were performed. This cohort of patients was evaluated at least 10 years after the primary replacement surgery. Altogether 323 knee replacements in 289 patients were evaluated. The clinical outcomes were assessed according to the Knee Society Clinical Rating System (KSS) and the Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. The replacement survival was evaluated using the Kaplan-Meier survival analysis. RESULTS In the evaluated group, the average KS was 82.6 points and the average functional score was 74.7 points. Excellent results were recorded in 213 cases, good results in 78 and satisfactory in 23 replacements. Poor clinical results were reported in 9 patients. The average range of motion was 105.8°. In 5 knees (1.5%) revision surgery was performed for infection complications, 3 cases were complicated due to periprosthetic fractures, 4 replacements were revised due to anterior knee pain and 8 knees showed a limited range of motion. Only 1 replacement was revised for aseptic loosening, with no need for reimplantation of the component. The survivorship of the implant was 98.5 % at the follow-up of 12.8 years, including the reasons of reimplantation. DISCUSSION Total knee replacement with an all-polyethylene tibial component is not so popular as the metal-backed modular implants. The all-polyethylene tibial component has certain advantages: lower unit costs, no backside wear, no liner dislocation, possibility of conservative bone resection. On the other hand, this type of implant is not modular and augmentations or longer stems cannot be used. Even though this type of endoprosthesis is recommended exclusively for elderly patients with a lower level of activity, the current mid- and long-term results show that indications for all-poly implants are much broader. CONCLUSIONS The total knee replacement with an all-polyethylene tibial component shows very good long-term clinical outcomes with an excellent survival rate. The all-poly design is cost-effective and may be used not only in elderly patients. Key words: total knee replacement, all-polyethylene tibial component, long-term results

In English

PURPOSE OF THE STUDY Use of an all-polyethylene (all-poly, AP) tibial component in primary total knee arthroplasty is still an attractive option considering the durability of replacement, the elimination of backside wear and the lower cost compared to modular metalbacked tibia. The purpose of the study was to evaluate the long-term results of the total knee replacement using the P.F.C. Sigma system with a monoblock all-polyethylene tibial component implanted at the 1st Orthopedic Department of the St. Anne's University Hospital and Masaryk University Brno in the period 1999-2010. MATERIAL AND METHODS In the monitored period, 911 total knee replacements using P.F.C. Sigma with an all-polyethylene tibial component were performed. This cohort of patients was evaluated at least 10 years after the primary replacement surgery. Altogether 323 knee replacements in 289 patients were evaluated. The clinical outcomes were assessed according to the Knee Society Clinical Rating System (KSS) and the Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. The replacement survival was evaluated using the Kaplan-Meier survival analysis. RESULTS In the evaluated group, the average KS was 82.6 points and the average functional score was 74.7 points. Excellent results were recorded in 213 cases, good results in 78 and satisfactory in 23 replacements. Poor clinical results were reported in 9 patients. The average range of motion was 105.8°. In 5 knees (1.5%) revision surgery was performed for infection complications, 3 cases were complicated due to periprosthetic fractures, 4 replacements were revised due to anterior knee pain and 8 knees showed a limited range of motion. Only 1 replacement was revised for aseptic loosening, with no need for reimplantation of the component. The survivorship of the implant was 98.5 % at the follow-up of 12.8 years, including the reasons of reimplantation. DISCUSSION Total knee replacement with an all-polyethylene tibial component is not so popular as the metal-backed modular implants. The all-polyethylene tibial component has certain advantages: lower unit costs, no backside wear, no liner dislocation, possibility of conservative bone resection. On the other hand, this type of implant is not modular and augmentations or longer stems cannot be used. Even though this type of endoprosthesis is recommended exclusively for elderly patients with a lower level of activity, the current mid- and long-term results show that indications for all-poly implants are much broader. CONCLUSIONS The total knee replacement with an all-polyethylene tibial component shows very good long-term clinical outcomes with an excellent survival rate. The all-poly design is cost-effective and may be used not only in elderly patients. Key words: total knee replacement, all-polyethylene tibial component, long-term results