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Cruciate-retaining TKA Using a Third-generation System with a Four-pegged Tibial Component: A Minimum 10-year Followup Note

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

A third-generation TKA system was designed to address problems encountered with earlier designs including a high rate of patellofemoral complications. At a minimum of 5 years, we previously reported survivorship of 98.7% using revision for any reason as the endpoint for a cohort that includes the patients described in this report. That cohort was unique in that a tibial component that uses four short pegs for fixation was used in a subset of patients undergoing cruciate-retaining TKA and the tibial and femoral components were precoated with polymethylmethacrylate.

Questions/purposes

We now report the survival rate, postoperative function, complications, radiographic loosening, and osteolysis at a minimum of 10 years postoperatively.

Patients and Methods

We retrospectively reviewed 161 patients who underwent 179 TKAs. The patella was resurfaced in all cases and all components were cemented. Patients were evaluated clinically and radiographically for evidence of component loosening and osteolysis. Forty of the 161 patients (with 44 TKAs) had died and eight patients (nine knees) were lost to followup. For the remaining 113 patients (126 knees), the minimum followup was 10 years (mean, 11.7 years; range, 10.0–13.9 years).

Results

Survivorship at a minimum of 10 years postoperatively using revision for any reason and revision for aseptic loosening were 97.7% and 100%, respectively. Three knees were revised: one for infection, one for periprosthetic fracture, and one for postoperative arthrofibrosis. There were no reoperations for patellar component maltracking, wear or loosening, tibiofemoral polyethylene wear, osteolysis, or aseptic loosening. Hospital for Special Surgery scores improved from a mean of 47.7 (range, 23–78) preoperatively to 85.4 (range, 33–100).

Conclusions

This cruciate-retaining design had a low risk of implant failure or revision and the design changes eliminated the patellar failures seen with earlier iterations at up to 10 years.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We acknowledge Peggy Arp, Reggie Barden, Laura Quigley, and Nicholas Ting for assistance with preparation of this manuscript.

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Authors and Affiliations

  1. Rush University Medical Center, 1725 W. Harrison Street, Suite 1063, Chicago, IL, 60612, USA

    Adam J. Schwartz MD, Craig J. Della Valle MD, Aaron G. Rosenberg MD, Joshua J. Jacobs MD, Richard A. Berger MD & Jorge O. Galante MD

Authors
  1. Adam J. Schwartz MD
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  2. Craig J. Della Valle MD
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  3. Aaron G. Rosenberg MD
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  4. Joshua J. Jacobs MD
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  5. Richard A. Berger MD
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  6. Jorge O. Galante MD
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Corresponding author

Correspondence to Craig J. Della Valle MD.

Additional information

One or more of the authors (CDV, AGR, JJJ, RAB, JOG) have received consulting fees, royalties, and/or research funding from Zimmer, Inc (Warsaw, IN). The institution of one or more of the authors (CDV, AGR, JJJ, RAB, JOG) has received funding from Zimmer, Inc.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Schwartz, A.J., Della Valle, C.J., Rosenberg, A.G. et al. Cruciate-retaining TKA Using a Third-generation System with a Four-pegged Tibial Component: A Minimum 10-year Followup Note. Clin Orthop Relat Res 468, 2160–2167 (2010). https://doi.org/10.1007/s11999-010-1360-2

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