Abstract
OBJETIVO: Avaliações dos resultados a médio prazo da aplicação da prótese com apoio tibial móvel. MÉTODOS: Noventa e seis pacientes (107 joelhos) foram submetidos a artroplastia total do joelho realizada com um modelo de prótese com mobilidade rotatória no componente tibial. Os pacientes foram avaliados após um seguimento médio de 52,7 meses - desvio padrão 21,94 (mínimo de 24 meses e máximo de 120 meses), através do protocolo de avaliação "Knee Society Clinical Rating System" (KSCRS), com uma média de 78,22 pontos. RESULTADOS: Entre as complicações transoperatórias e pós operatórias imediatas ocorreram uma deiscência de sutura, com cura espontânea, duas fraturas de patela, uma fratura do côndilo medial do fêmur, três paresias do nervo fibular lateral e uma distrofia nervosa simpático reflexa. As complicações tardias foram uma fratura da patela, uma fratura distal do fêmur, quatro solturas assépticas e quatro infecções profundas, que necessitaram de revisão. CONCLUSÃO: Excluindo-se os casos que necessitaram de uma revisão, por soltura séptica ou asséptica, os autores concluem serem bons os resultados clínicos e funcionais obtidos com a prótese com o apoio tibial móvel num seguimento a médio prazo.
Highlights
Knee prostheses should offer high durability, if possible above 20 years, avoiding their loosening or excessive wear of the polyethylene, by means of a design that respects details of the anatomy, the kinematics and the joint physiology
Some authors advocate that total knee replacements with rotating bearing have the advantage of standardizing the contact pressures among components, reducing the formation of polyethylene particles and, osteolysis, besides promoting better adaptation of the extensor mechanism to possible imperfections in the rotational positioning of the tibial component.[4]
The analysis of the results of international studies showing the durability and good function of mobile bearing total knee replacements stimulated their use in our field
Summary
Knee prostheses should offer high durability, if possible above 20 years, avoiding their loosening or excessive wear of the polyethylene, by means of a design that respects details of the anatomy, the kinematics and the joint physiology. This condition will enable the expansion of their indications, including younger patients, if the risk of premature failure and all the adversities that may arise in arthroplasty reviews are decreased.[1] The concept of knee arthroplasties with mobile tibial bearing was introduced in 1978 by Goodfellow and O’Connor[2]. Tibial component fixation in inadequate rotation increases incongruity, causing an increase in the patellofemoral contact pressure due to poor alignment; if the polyethylene component is mobile it will adapt to the condyles, promoting automatic rotation of the tibia, imitating the movements of the normal knee.[5,6] Several studies have exhibited good results on the long terms with the use of these implants, both those that use two isolated tibial components connected to the metallic base (meniscal prostheses) and those of a single mobile plastic component.[7,8,9,10] some authors indicate the need for studies with a long follow-up, proving clinical advantages and survival, in comparison to implants with fixed tibial bearing.[11,12] Another factor is the possibility of platform displacement, a complication that frequently requires review arthroplasty.[10,12,13] The analysis of the results of international studies showing the durability and good function of mobile bearing total knee replacements stimulated their use in our field
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
