Primary total stabizer knee arthroplasty: clinical and radiographic outcomes at short-mid-term follow-up
ESSKA Academy. Giuntoli M. Nov 8, 2019; 284368; epEKA-28 Topic: Joint Replacement
Dr. Michele Giuntoli
Dr. Michele Giuntoli
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Primary total stabizer knee arthroplasty: clinical and radiographic outcomes at short-mid-term follow-up

ePoster - epEKA-28

Topic: TKA

Bonicoli E., Piolanti N., Giuntoli M., Polloni S., Ciapini G., Parchi P.D., Scaglione M.
Università Degli Studi di Pisa, Pisa, Italy

Introduction: A successful Total Knee Arthroplasty (TKA) requires stability, but rarely, in primary TKA, the use of a prosthesis with more constraint than a posterior-stabilizer (PS) is necessary. In patients with severe varus/valgus deformities, with incompetent collateral ligaments or in those knees that cannot be adequately balanced after ligaments release, a total-stabilizer (TS) prosthesis may be require.
Objectives: To evaluate clinical and radiographic outcomes at a short-mid-term follow-up (FU) in patients treated with a primary TS TKA.
Methods: From January 2013 to August 2016, 36 patients (38 knees) were treated with Stryker Triathlon TS cemented implants. Clinical and radiographic evaluation were performed preoperatively and postoperatively at 1 month, 3 months, 6 months, 1 year, and at 1-year intervals thereafter. At final follow-up, 33 patients (35 knees) were included in the study. Clinical evaluation was performed using the WOMAC score and the Knee Society rating system (subdivided into a knee score - KS - and a functional score - FS). Radiographic evaluation consisted of AP standing and lateral views: the anatomical Femoral-Tibial Angle (aFTA) and the Radiolucent Lines (RLLs) were reported.
Results: The mean FU was 26,6 months (range: 13-55). KS and FS increased significantly from a mean pre-operative value of 48 and 45 to 86 and 82 at last FU, respectively. The WOMAC score decreased significantly from 45 to 19 at last FU.
At x-rays we assumed an aFTA of 176°±2° as normal. The mean pre-operative aFTA in varus knees was 183,7° (range 182°-185°) while the mean pre-operative aFTA in valgus knees was 156.3° (range 172°-148°). The mean post-operative aFTA was 176,5°. We found out RLLs around tibial stem in 3 cases at last FU, but we didn't found any sings of Polyethylene wear or osteolysis.
Conclusions: When an adequately prosthesis balancing isn't possible a valid option is to perform a TKA with a total stabilizer polyethylene insert. TS prosthesis gives more stability during the most of ROM and the prosthesis design we used provides the possibility to shift from PS polyethylene insert to a TS one intra-operatively: surgeon can increase the implant constraint without replace prosthesis components. In our study we report good clinical and radiographic outcomes at a short-mid-term follow-up with a low-rate of complications.
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