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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 23, Issue 6, pp 1598–1609 | Cite as

Patients achieved greater range of movement when using high-flexion implants

  • Canfeng Li
  • Yi Zeng
  • Bin ShenEmail author
  • Jing Yang
  • Zongke Zhou
  • Pengde Kang
  • Fuxing Pei
Knee

Abstract

Purpose

NexGen Legacy Posterior Stabilized high-flexion prostheses (LPS-Flex) have been popularized as an alternative to NexGen standard prostheses (LPS) in total knee arthroplasty (TKA). Advocates of this new generation prosthesis suggest improved postoperative knee flexion. The purpose of this study was to summarize the best evidence for comparing the range of motion (ROM) and functional outcomes of LPS-Flex prostheses and LPS in TKA.

Methods

Electronic databases were systematically searched to identify relevant randomized controlled trials (RCTs). The last date for our research was July 2014. Our search strategy was followed the requirements of the Cochrane Library Handbook. The methodological quality was assessed, and the data were extracted independently by two authors.

Results

Nine studies that included 978 knees met our inclusion criteria for review. The results showed that there was larger postoperative ROM (1.62, 95 % CI 0.52–2.72) in the LPS-Flex group than in the LPS group. There was not a statistically significant difference in the clinical functional scores and complications between the LPS-Flex group and the LPS group in TKA. The pooled mean differences were as follows: total KSS, −0.64 (95 % CI −1.41 to 0.13); functional KSS, −0.53 (95 % CI −1.51 to 0.45); HSS, 0.23 (95 % CI −0.87 to 1.33); complications, 0.49 (95 % CI 0.20–1.24); and radiolucent lines, 1.56 (95 % CI 0.68–3.55).

Conclusions

The preliminary results indicate that the NexGen LPS-Flex prosthesis provides an alternative to the NexGen LPS prosthesis, with greater range of motion and without severe complications or radiographic outcomes. The clinical advantages were not shown in the KSS or the HSS. Thus, the selection of a high-flexion prosthesis should depend on the characteristics of the patient, particularly high motivation and poor preoperative ROM. The potential benefits in the medium- and long-term outcomes require confirmation by larger, multicenter and well-conducted RCTs.

Level of evidence

Therapeutic study, Level I.

Keywords

High-flexion prosthesis Standard prosthesis Range of motion Total knee arthroplasty 

Notes

Acknowledgments

This research was funded by the China Health Ministry Program (201302007). No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2014

Authors and Affiliations

  • Canfeng Li
    • 1
  • Yi Zeng
    • 1
  • Bin Shen
    • 1
    Email author
  • Jing Yang
    • 1
  • Zongke Zhou
    • 1
  • Pengde Kang
    • 1
  • Fuxing Pei
    • 1
  1. 1.The Orthopedic Department, West China HospitalSichuan UniversityChengduChina

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