ReviewCanadian journal of surgery. Journal canadien de chirurgie
Semiconstrained posterior-stabilized total knee arthroplasty: indications, risks and benefits in primary and revision surgery.
Review in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors at 3 institutions in 2 countries.
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Abstract
backgroundThe constrained posterior-stabilized (CPS) implant for use in total knee arthroplasty (TKA) has a constraint level midway between that of a posterior-stabilized implant and a valgus-varus-constrained implant; there is currently no consensus on the surgical indications for use of this degree of constraint. We present our experience using this implant at our centre.
methodsWe reviewed the charts of patients who received a CPS polyethylene insert during TKA in our centre between January 2016 and April 2020. We collected patient demographic characteristics, surgical indications, pre- and postoperative radiographs, and complications.
resultsA total of 85 patients (74 females and 11 males with a mean age of 73 yr [standard deviation 9.4 yr, range 36-88 yr]) (85 knees) received a CPS insert over the study period. Of the 85 cases, 80 (94%) were primary TKA and 5 (6%) were revision TKA. The most common indications for primary CPS use were severe valgus deformity with medial soft-tissue laxity (29 patients [34%]), medial soft-tissue laxity without substantial deformity (27 [32%]) and severe varus deformity with lateral soft-tissue laxity (13 [15%]). The indications for the 5 patients who underwent revision TKA were medial laxity (4 patients) and an iatrogenic lateral condyle fracture (1 patient). Four patients had postoperative complications. The 30-day return to hospital rate was 2.3% (owing to infection and hematoma). A single patient required revision surgery for periprosthetic joint infection.
conclusionWe found excellent short-term survivorship of the CPS polyethylene insert when used for a spectrum of coronal plane ligamentous imbalances with or without pre-operative coronal plane deformities. Long-term follow-up of these cases will be important to identify adverse outcomes such as loosening or polyethylene-related problems.
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