Skip to main content
SpringerLink
Log in

Results of total knee arthroplasty with NexGen LPS-Flex for osteoarthritis in the valgus knee: a study of 26 patients followed for a minimum of 2 years

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

The present study aimed to examine the results of total knee arthroplasty (TKA) with the NexGen Legacy posterior-stabilized (LPS)-Flex system for osteoarthritis in the valgus knee. Between 2003 and 2011, 27 valgus knees in 26 patients who underwent TKA with the NexGen LPS-Flex implant were clinically and radiologically evaluated after a minimum follow-up of 2 years. The original diagnosis was osteoarthritis. Knee Society Knee Score (KSKS), Knee Society Function Score (KSFS), maximum flexion angle, maximum extension angle, and radiological femorotibial angle (FTA) were evaluated pre- and postoperatively. The mean KSKS improved from 42.6 before surgery to 82.2 by the final follow-up (p < 0.01), and the mean KSFS improved from 41.1 to 80.9 (p < 0.01). The mean maximum flexion angle changed from 109.1° to 117.3° (no statistical significance) and the maximum extension angle improved from −9.7° to −3.6° (p < 0.05) postoperatively. The postoperative radiological FTA was 172.4°, which was closer to a neutral angle (174°) than the preoperative FTA (166.4°) (p < 0.01). None of the patients had undergone revision surgery by the final follow-up. As a conclusion, TKA with the NexGen LPS-Flex implant for osteoarthritis in the valgus knee resulted in satisfactory improvement regarding objective outcomes, although a longer term follow-up with a greater number of cases is necessary to verify these results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Anouchi YS, McShane M, Kelly F Jr, Elting J, Stiehl J (1996) Range of motion in total knee replacement. Clin Orthop Relat Res 331:87–92

    Article  PubMed  Google Scholar 

  2. Kurosaka M, Yoshiya S, Mizuno K, Yamamoto T (2002) Maximizing flexion after total knee arthroplasty: the need and the pitfalls. J Arthroplasty 17:59–62

    Article  PubMed  Google Scholar 

  3. Ritter MA, Harty LD, Davis KE, Meding JB, Berend ME (2003) Predicting range of motion after total knee arthroplasty. Clustering, log-linear regression, and regression tree analysis. J Bone Joint Surg Am 85A(7):1278–1285

    Google Scholar 

  4. D’Lima DD, Patil S, Steklov N, Colwell CW Jr (2007) An ABJS best paper: dynamic intraoperative ligament balancing for total knee arthroplasty. Clin Orthop Relat Res 463:208–212

    PubMed  Google Scholar 

  5. Parratte S, Pagnano MW (2008) Instability after total knee arthroplasty. J Bone Joint Surg Am 90(1):184–194

    PubMed  Google Scholar 

  6. Ranawat AS, Ranawat CS, Elkus M, Rasquinha VJ, Rossi R, Babhulkar S (2005) Total knee arthroplasty for severe valgus deformity. J Bone Joint Surg Am 87:271–284

    PubMed  Google Scholar 

  7. Aglietti P, Buzzi R, Giron F, Zaccherotti G (1996) The Insall-Burstein posterior stabilized total knee replacement in the valgus knee. Am J Knee Surg 9(1):8–12

    CAS  PubMed  Google Scholar 

  8. Hood RW, Vanni M, Insall JN (1981) The correction of knee alignment in 225 consecutive total condylar knee replacements. Clin Orthop Relat Res 160:94–105

    PubMed  Google Scholar 

  9. Miyasaka KC, Ranawat CS, Mullaji A (1997) 10- to 20-year followup of total knee arthroplasty for valgus deformities. Clin Orthop Relat Res 345:29–37

    Article  PubMed  Google Scholar 

  10. Stern SH, Moeckel BH, Insall JN (1991) Total knee arthroplasty in valgus knees. Clin Orthop Relat Res 273:5–8

    PubMed  Google Scholar 

  11. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14

    PubMed  Google Scholar 

  12. Li G, Most E, Sultan PG et al (2004) Knee kinematics with a high-flexion posterior stabilized total knee prosthesis: an in vitro robotic experimental investigation. J Bone Joint Surg Am 86A(8):1721–1729

    Google Scholar 

  13. D’Lima DD, Steklov N, Fregly BJ, Banks SA, Colwell CW Jr (2008) In vivo contact stresses during activities of daily living after knee arthroplasty. J Orthop Res 26(12):1549–1555

    Article  PubMed  Google Scholar 

  14. Sharma A, Komistek RD, Scuderi GR, Cates HE Jr (2007) High-flexion TKA designs: what are their in vivo contact mechanics? Clin Orthop Relat Res 464:117–126

    PubMed  Google Scholar 

  15. Tarabichi S, Tarabichi Y, Hawari M (2010) Achieving deep flexion after primary total knee arthroplasty. J Arthroplasty 25(2):219–224

    Article  PubMed  Google Scholar 

  16. Ranawat CS (2003) Design may be counterproductive for optimizing flexion after TKR. Clin Orthop Relat Res 416:174–176

    Article  PubMed  Google Scholar 

  17. Ritter MA (2006) High-flexion knee designs: more hype than hope? In the affirmative. J Arthroplasty 21:40–41

    Article  PubMed  Google Scholar 

  18. Sancheti KH, Sancheti PK, Shyam AK, Joshi R, Patil K, Jain A (2013) Factors affecting range of motion in total knee arthroplasty using high flexion prosthesis: a prospective study. Indian J Orthop 47(1):50–56

    Article  PubMed Central  PubMed  Google Scholar 

  19. Bin SI, Nam TS (2007) Early results of high-flex total knee arthroplasty: comparison study at 1 year after surgery. Knee Surg Sports Traumatol Arthrosc 15(4):350–355

    Article  PubMed  Google Scholar 

  20. Gupta SK, Ranawat AS, Shah V, Zikria BA, Zikria JF, Ranawat CS (2006) The P.F.C. sigma RP-F TKA designed for improved performance: a matched-pair study. Orthopedics 29:S49–S52

    PubMed  Google Scholar 

  21. Huang HT, Su JY, Wang GJ (2005) The early results of high-flex total knee arthroplasty: a minimum of 2 years of follow-up. J Arthroplasty 20(5):674–679

    Article  PubMed  Google Scholar 

  22. Choi WC, Lee S, Seong SC, Jung JH, Lee MC (2010) Comparison between standard and high-flexion posterior-stabilized rotating-platform mobile-bearing total knee arthroplasties: a randomized controlled study. J Bone Joint Surg Am 92(16):2634–2642

    Article  PubMed  Google Scholar 

  23. Kim YH, Sohn KS, Kim JS (2005) Range of motion of standard and high-flexion posterior stabilized total knee prostheses. A prospective, randomized study. J Bone Joint Surg Am 87(7):1470–1475

    Article  PubMed  Google Scholar 

  24. Nutton RW, van der Linden ML, Rowe PJ, Gaston P, Wade FA (2008) A prospective randomised double-blind study of functional outcome and range of flexion following total knee replacement with the NexGen standard and high flexion components. J Bone Joint Surg Br 90(1):37–42

    Article  CAS  PubMed  Google Scholar 

  25. Murphy M, Journeaux S, Russell T (2009) High-flexion total knee arthroplasty: a systematic review. Int Orthop 33(4):887–893

    Article  PubMed Central  PubMed  Google Scholar 

  26. Krackow KA, Jones MM, Teeny SM, Hungerford DS (1991) Primary total knee arthroplasty in patients with fixed valgus deformity. Clin Orthop Relat Res 273:9–18

    PubMed  Google Scholar 

  27. Elkus M, Ranawat CS, Rasquinha VJ, Babhulkar S, Rossi R, Ranawat AS (2004) Total knee arthroplasty for severe valgus deformity. Five to fourteen-year follow-up. J Bone Joint Surg Am 86A(12):2671–2676

    Google Scholar 

  28. Nagura T, Dyrby CO, Alexander EJ, Andriacchi TP (2002) Mechanical loads at the knee joint during deep flexion. J Orthop Res 20(4):881–886

    Article  PubMed  Google Scholar 

  29. Suggs JF, Hanson GR, Park SE, Moynihan AL, Li G (2008) Patient function after a posterior stabilizing total knee arthroplasty: cam-post engagement and knee kinematics. Knee Surg Sports Traumatol Arthrosc 16(3):290–296

    Article  PubMed  Google Scholar 

  30. Koskinen E, Remes V, Paavolainen P, Harilainen A, Sandelin J, Tallroth K et al (2011) Results of total knee replacement with a cruciate-retaining model for severe valgus deformity-a study of 48 patients followed for an average of 9 years. Knee 18(3):145–150

    Article  PubMed  Google Scholar 

  31. Idusuyi OB, Morrey BF (1996) Peroneal nerve palsy after total knee arthroplasty. Assessment of predisposing and prognostic factors. J Bone Joint Surg Am 78(2):177–184

    CAS  PubMed  Google Scholar 

  32. Piedade SR, Pinaroli A, Servien E, Neyret P (2009) Revision after early aseptic failures in primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 17(3):248–253

    Article  PubMed  Google Scholar 

  33. Scuderi GR, Bourne RB, Noble PC, Benjamin JB, Lonner JH, Scott WN (2012) The new knee society knee scoring system. Clin Orthop Relat Res 470(1):3–19

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Naoki Nakano, Tomoyuki Matsumoto, Takehiko Matsushita, Koji Takayama, Tokio Matsuzaki, Ryosuke Kuroda & Masahiro Kurosaka

  2. Department of Orthopaedic Surgery, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, 671-1122, Japan

    Hirotsugu Muratsu

Authors
  1. Naoki Nakano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomoyuki Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hirotsugu Muratsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takehiko Matsushita
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Koji Takayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tokio Matsuzaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ryosuke Kuroda
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Masahiro Kurosaka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomoyuki Matsumoto.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nakano, N., Matsumoto, T., Muratsu, H. et al. Results of total knee arthroplasty with NexGen LPS-Flex for osteoarthritis in the valgus knee: a study of 26 patients followed for a minimum of 2 years. Eur J Orthop Surg Traumatol 25, 375–380 (2015). https://doi.org/10.1007/s00590-014-1505-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-014-1505-1

Keywords

Search

Navigation