0
Scientific Articles   |    
Uncemented Rotating-Platform Total Knee Replacement: A Five to Twelve-Year Follow-up Study
R. Barry Sorrells, MD1; Paul E. Voorhorst, MS2; Jeffrey A. Murphy, MS2; Maryrose P. Bauschka, BA3; A. Seth Greenwald, DPhil(Oxon)3
1 The Joint Replacement Clinic, 8907 Kanis Road, Suite 300, Little Rock, AR 72205
2 DePuy Orthopaedics, P.O. Box 988, 700 Orthopaedic Drive, Warsaw, IN 46581
3 Orthopaedic Research Laboratories, Lutheran Hospital, Cleveland Clinic Health System, 1730 West 25th Street, Cleveland, OH 44113. E-mail address for A.S. Greenwald: seth@orl-inc.com
View Disclosures and Other Information
In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from DePuy, a division of Johnson and Johnson. In addition, one or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (DePuy, Inc.). No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
A video supplement to this article is available from theVideo Journal of Orthopaedics.A video clip is available at the JBJS web site, www.jbjs.org. TheVideo Journal of Orthopaedicscan be contacted at (805) 962-3410, web site: www.vjortho.com.
A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM (call our subscription department, at 781-449-9780, to order the CD-ROM).
Investigation performed at the Joint Replacement Clinic, Little Rock, Arkansas

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 Oct 01;86(10):2156-2162
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Abstract

Background: Mobile-bearing knee designs represent an alternative to conventional fixed-bearing total knee arthroplasty. We present the results of a prospective, intermediate-term clinical follow-up study of the bicruciate ligament-sacrificing porous-coated Low Contact Stress rotating-platform total knee design.

Methods: Between February 1984 and January 1994, 528 uncemented primary knee replacements were performed in 421 patients. All patellae were resurfaced with use of the Low Contact Stress rotating patellar component. The average age of the patients at the time of the index procedure was sixty-nine years. The study group included 261 women and 160 men. Patients were evaluated at three months, six months, and yearly thereafter with use of the 100-point New Jersey Orthopaedic Hospital knee-scoring system. In addition, a radiographic analysis of the tibial, femoral, and patellar components was performed at each interval.

Results: There were twenty-nine failures that resulted in revision. The Kaplan-Meier estimate of implant survival at twelve years was 89.5% (95% confidence interval, 83.4% to 95.6%). The total clinical scores improved significantly compared with the preoperative scores for the first twelve months postoperatively and then plateaued. Three hundred and twenty-one knees had adequate radiographic follow-up (average, 8.1 years; range, five to twelve years). Zonal radiographic analysis revealed ninety-three instances of radiolucent lines (eighty-two of which measured <1 mm in width), with the greatest number of radiolucent lines (thirty-nine) being located around the tibial tray stem. None of these lines were deemed to be progressive, and no knee with a radiolucent line that measured >2 mm was revised because of failure.

Conclusions: This first-generation uncemented, mobile-bearing, bicruciate ligament-sacrificing knee replacement was associated with a good survival rate and demonstrated clinical efficacy during the five to twelve-year follow-up interval.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.

Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    03/19/2014
    Virginia - VIRGINIA COMMONWEALTH UNIVERSITY MEDICAL CENTER
    01/08/2014
    Pennsylvania - Penn State Milton S. Hershey Medical Center
    03/19/2014
    Massachusetts - The University of Massachusetts Medical School