Abstract
BackgroundThe application of new techniques and materials in total knee arthroplasty (TKA) continue to be a primary focus in orthopedic surgery. The primary aim of the present study is to evaluate post TKA total range of motion (ROM) among a group of patients who received a gender specific high-flexion design modification implant compared to a control group of patients who received non-gender specific implants.Methods and resultsThe control group was comprised of 39 TKAs that were recruited pre-operatively and received the non-gender specific implant while the study group consisted of 39 TKAs who received gender specific implants. The study group yielded an improvement in mean post-operative ROM of 21° at 12 months, whereas the mean improvement in ROM among the control group was 11°. Thus, the study group had a 10° increased ROM improvement (91%) over the control group (p = 0.00060). In addition, 100% of the subjects with gender specific high-flexion implants achieved greater or equal ROM post-operatively compared to 82% for the control cohort. Lastly, women who exhibited greater pre-operative ROM and lower body mass index (BMI) were found to benefit the most with the gender specific prosthesis.ConclusionOur study demonstrates that among subjects with a normal BMI, the gender specific high-flexion knee implant is associated with increased ROM as compared to the non-gender specific non-high-flexion implant designs.
Highlights
The application of new techniques and materials in total knee arthroplasty (TKA) continue to be a primary focus in orthopedic surgery
Our study demonstrates that among subjects with a normal body mass index (BMI), the gender specific high-flexion knee implant is associated with increased range of motion (ROM) as compared to the non-gender specific non-high-flexion implant designs
Results from the study indicated that prosthetic manufacturers were skilled at supplying implant sizes that fit the average patient within the population of those undergoing TKA
Summary
The application of new techniques and materials in total knee arthroplasty (TKA) continue to be a primary focus in orthopedic surgery. The development of intramedullary and extramedullary cutting instruments and enhanced fixation techniques in the 1970’s led to advancements in prosthesis design and surgical expertise in the 1980’s that have facilitated longterm implant survival [1,2,3] Few changes in this evolution; have resulted in proven, lasting improvement of performance despite the plethora of claims in the literature of early recovery, functional excellence, and patient satisfaction. The Zimmer NexGen implant sizes lie just above the best fit (least squares regression) line for combined male and female morphological data. These “unisex” implants are inadequate at fitting larger-boned women whose femoral A/P measurements exceed 60 mm. Such medial or lateral overhang has been conjectured to result in soft tissue irritation complicated balancing efforts
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