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Revision total knee arthroplasty with varus–valgus constrained prosthesis versus posterior stabilized prosthesis

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aims of this retrospective study were to provide the basis for the choice of prosthesis in revision total knee arthroplasty (TKA) and to evaluate the outcome with varus–valgus constrained prosthesis compared with posterior stabilized (PS) prosthesis.

Methods

One hundred and five patients (121 knees) received revision TKA; of which thirty-seven patients (42 knees) received PS prosthesis and sixty-eight patients (79 knees) received varus–valgus constrained prosthesis. The mean follow-up duration was 64.8 ± 31.5 months and 63.2 ± 28.1 months in the PS and varus–valgus constrained groups, respectively. The criterion of prosthesis choice was a subjective laxity assessed by the surgeon intraoperatively. A multivariate analysis was performed to evaluate the preoperative factors in the choice of the prosthesis.

Results

The grade of femoral bone defect was the only factor that affected the choice of prosthesis. Clinical results improved significantly in both groups after surgery. There were no significant differences in clinical results between the two groups. Complication rates were 9.5 % in the PS group and 10.1 % in the varus–valgus constrained group, and the Kaplan–Meier survivorship analysis revealed 8-year component survival rates of 83.1 and 93.0 % in the PS and varus–valgus constrained groups, respectively.

Conclusions

Femoral bone defect is an important factor to be considered in the choice of prosthesis for revision TKA. The varus–valgus constrained prosthesis showed an outcome similar to that of the PS prosthesis. For clinical relevance, varus–valgus constrained prosthesis is recommended in revision TKA when the PS prosthesis seems unsuitable for the management of instability.

Level of evidence

III.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea

    Joon Kyu Lee, Sahnghoon Lee, Jak Jang, Sang Cheol Seong & Myung Chul Lee

  2. Department of Orthopaedic Surgery, The Armed Forces Capital Hospital, 2 Yul-dong, Bundang-gu, Seongnam, Gyeonggi-do, 463-040, Korea

    Dongwook Kim

  3. Department of Orthopaedic Surgery, Eulji University College of Medicine, 1306 Dunsan-dong Seo-gu, Daejeon, 302-799, South Korea

    Sang Min Lee

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  1. Joon Kyu Lee
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  2. Sahnghoon Lee
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  3. Dongwook Kim
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  4. Sang Min Lee
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  5. Jak Jang
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  6. Sang Cheol Seong
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  7. Myung Chul Lee
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Correspondence to Myung Chul Lee.

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Lee, J.K., Lee, S., Kim, D. et al. Revision total knee arthroplasty with varus–valgus constrained prosthesis versus posterior stabilized prosthesis. Knee Surg Sports Traumatol Arthrosc 21, 620–628 (2013). https://doi.org/10.1007/s00167-012-1998-2

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  • DOI: https://doi.org/10.1007/s00167-012-1998-2

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