Abstract
The aim of this study was to compare the long-term implant survival and outcomes in patients with high-flexion cruciate-retaining (CR) or high-flexion posterior cruciate-substituting (PS) knee implants. A total of 253 knees (CR group: 159 vs. PS group: 94) were available for examination over a mean follow-up of 10 years. Clinical outcomes were assessed including the Hospital for Special Surgery score, Knee Society score and Western Ontario and McMaster Universities Osteoarthritis Index score at the final follow-up. Radiologic measurements were also assessed including the hip-knee-ankle angle and radiolucent lines according to the KSS system at the final follow-up. The survival rate was analyzed using the Kaplan–Meier method. At the final follow-up, the mean total HSS scores were similar between the two groups (p = 0.970). The mean hip-knee-ankle angle at the final follow-up was similar between groups (p = 0.601). The 10- and 15-year survival rates were 95.4% and 93.3% in the CR group and 92.7% and 90.9% in the PS group, respectively, with no significant difference. Similar clinical and radiographic outcomes could be achieved with both the high-flexion CR and high-flexion PS total knee designs without a difference in survival rate after a 10-year follow-up.
Highlights
The aim of this study was to compare the long-term implant survival and outcomes in patients with high-flexion cruciate-retaining (CR) or high-flexion posterior cruciate-substituting (PS) knee implants
The preoperative clinical scores showed no significant differences between the two groups (Table 1)
The clinical results at the final follow-up had no statistical significant between the CR and PS groups regard of Hospital for Special Surgery (HSS) score (p = 0.970), KSS pain score (p = 0.565), KSS function score (p = 0.125), and WOMAC score (p = 0.338). (Table 2)
Summary
The aim of this study was to compare the long-term implant survival and outcomes in patients with high-flexion cruciate-retaining (CR) or high-flexion posterior cruciate-substituting (PS) knee implants. Similar clinical and radiographic outcomes could be achieved with both the high-flexion CR and high-flexion PS total knee designs without a difference in survival rate after a 10-year follow-up. To meet the patients’ expectation for a high range of motion (ROM), the high-flexion prosthesis design (NexGen LPS-Flex; Zimmer Inc., Warsaw, IN, USA) was introduced in TKA These high-flexion designs are not radically different from their conventional design counterparts. The aim of this study was to compare high-flexion CR and high-flexion PS prostheses in terms of complications including aseptic loosening and radiolucent lines, clinical and radiologic outcomes, and long-term survival rate after a mean follow-up of 10 years. The hypothesis was that there are no significant differences in outcomes between high-flexion PS knee implant and the high-flexion CR knee implant after a long-term follow-up
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