No difference in failure rates or clinical outcomes between non-stemmed constrained condylar prostheses and posterior-stabilized prostheses for primary total knee arthroplasty

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2020-09, Vol.28 (9), p.2942-2947
• Main Authors: Dayan, Isaac, Moses, Michael J., Rathod, Parthiv, Deshmukh, Ajit, Marwin, Scott, Dayan, Alan J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arthroplasty (knee); Arthroplasty, Replacement, Knee - methods; Biomedical materials; Cementing; Cholecystokinin; Clinical outcomes; Demographics; Demography; Failure rates; Female; Humans; Inserts; Joint surgery; Knee; Knee Joint - surgery; Knee Prosthesis; Male; Medical personnel; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Osteoarthritis, Knee - surgery; Outcome Assessment, Health Care; Prostheses; Prosthesis Failure - trends; Prosthetics; Range of Motion, Articular; Retrospective Studies; Surgical implants
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-019-05684-z

Purpose There has been an increase in the use of unlinked constrained condylar knee (CCK) prostheses in primary total knee arthroplasty (TKA) for cases with significant deformities that cannot be adequately balanced in flexion and extension. However, the literature on its outcomes is limited. The goal of this study is to evaluate whether there are any clinic or radiographic outcome differences for a primary, non-stemmed, unlinked constrained TKA as compared to a control group of posterior-stabilized (PS) TKA using the same implant design. Methods Clinical and radiographic outcome measures for 404 cemented, non-stemmed, primary TKAs performed by two surgeons at the same institution were retrospectively reviewed. All patients underwent primary, non-stemmed components; 241 used CCK inserts and 163 used PS inserts. Preoperative deformity, knee society scores (KSS), range-of-motion (ROM), radiographic data and revision rates were compared between the CCK and PS groups. Results Both groups had comparable demographics and preoperative ROM and KSS. At similar mean follow-up times (6.1 ± 1.0 years for the CCK group and 6.3 ± 1.2 years for the PS group), no significant difference was found in ROM, KSS or radiographic outcomes. Revision rates were higher for the CCK group (2%) as compared to the HF-PS (0.6%) group (n.s). Conclusions The particular design of cemented, primary, non-stemmed, unlinked CCK-TKA examined in this study provided similar clinical and radiographic outcomes to that of PS-TKA at midterm follow-up. Level of evidence III.