Total knee arthroplasty revision with ...
Document type :
Compte-rendu et recension critique d'ouvrage
Title :
Total knee arthroplasty revision with trabecular tantalum cones: Preliminary retrospective study of 51 patients from two centres with a minimal 2-year follow-up
Author(s) :
Girerd, D. [Auteur]
Parratte, S. [Auteur]
Institut du Mouvement et de l’appareil Locomoteur [Hôpital Sainte-Marguerite - APHM] [IML]
Institut des Sciences du Mouvement Etienne Jules Marey [ISM]
Lunebourg, A. [Auteur]
Boureau, F. [Auteur]
Ollivier, M. [Auteur]
Institut des Sciences du Mouvement Etienne Jules Marey [ISM]
Institut du Mouvement et de l’appareil Locomoteur [Hôpital Sainte-Marguerite - APHM] [IML]
Pasquier, G. [Auteur]
Université Lille Nord de France (COMUE)
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]
Putman, S. [Auteur]
Migaud, H. [Auteur]
Université Lille Nord de France (COMUE)
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]
Argenson, Jean-Noël [Auteur]
Institut du Mouvement et de l’appareil Locomoteur [Hôpital Sainte-Marguerite - APHM] [IML]
Institut des Sciences du Mouvement Etienne Jules Marey [ISM]
Parratte, S. [Auteur]
Institut du Mouvement et de l’appareil Locomoteur [Hôpital Sainte-Marguerite - APHM] [IML]
Institut des Sciences du Mouvement Etienne Jules Marey [ISM]
Lunebourg, A. [Auteur]
Boureau, F. [Auteur]
Ollivier, M. [Auteur]
Institut des Sciences du Mouvement Etienne Jules Marey [ISM]
Institut du Mouvement et de l’appareil Locomoteur [Hôpital Sainte-Marguerite - APHM] [IML]
Pasquier, G. [Auteur]
Université Lille Nord de France (COMUE)
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]
Putman, S. [Auteur]
Migaud, H. [Auteur]
Université Lille Nord de France (COMUE)
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 [MABLab]
Argenson, Jean-Noël [Auteur]
Institut du Mouvement et de l’appareil Locomoteur [Hôpital Sainte-Marguerite - APHM] [IML]
Institut des Sciences du Mouvement Etienne Jules Marey [ISM]
Journal title :
Orthopaedics & Traumatology: Surgery & Research
Pages :
429-433
Publisher :
Elsevier
Publication date :
2016-06
ISSN :
1877-0568
HAL domain(s) :
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Chirurgie
Physique [physics]/Mécanique [physics]/Biomécanique [physics.med-ph]
Physique [physics]/Mécanique [physics]/Biomécanique [physics.med-ph]
English abstract : [en]
Background: Successful management of large bone defects is of crucial importance when performing revision total knee arthroplasty (TKA). Trabecular tantalum cones may improve prosthesis fixation via their potential for ...
Show more >Background: Successful management of large bone defects is of crucial importance when performing revision total knee arthroplasty (TKA). Trabecular tantalum cones may improve prosthesis fixation via their potential for reconstructing a stable metaphyseal support. The objective of this study was to evaluate the clinical and radiological outcomes and the complications of tantalum cones in revision TKA. Hypothesis: Trabecular tantalum cones provide stable and durable metaphyseal reconstruction when used during revision TKA. Material and methods: Trabecular Metal (TM) cones (Zimmer, Warsaw, IN, USA) were used for 52 revision TKAs in 51 patients (mean age, 68 +/- 9 years) managed in two centres between 2008 and 2013. A rotating hinge prosthesis was chosen for 38 (73%) knees and a condylar constrained knee prosthesis for 14 (27%) knees, with 37 tibial and 34 femoral cones. The two most common reasons for revision surgery were aseptic loosening (n= 22, 42%) and infection (n=19, 37%). The bone loss was severe in most cases. At each centre, after a mean follow-up of 34 months (range, 24-52 months), two independent observers assessed the Knee Society Score (KSS), range of motion, mechanical axis, and osteo-integration for each patient. Results: Mean KSS increased from 46 preoperatively to 77 (P=0.001) at last follow-up and the mean KSS function from 39 to 57 (P=0.007). Mean range of motion improved from 93 degrees (45 degrees-120 degrees) to 110 (65 degrees-130 degrees) (P= 0.001). Mean postoperative mechanical axis was 180 degrees (172 degrees-190 degrees). Radiographic evaluation showed evidence of osteo-integration for all cones. Four revisions were performed for recurrence of infection but none for mechanical failure. Discussion: The findings of our study confirm the biomechanical and biological reliability of Trabecular Metal (TM) cones used to fill metaphyseal bone defects during revision TKA. Level of evidence: IV, retrospective therapeutic study. (C) 2016 Elsevier Masson SAS. All rights reserved.Show less >
Show more >Background: Successful management of large bone defects is of crucial importance when performing revision total knee arthroplasty (TKA). Trabecular tantalum cones may improve prosthesis fixation via their potential for reconstructing a stable metaphyseal support. The objective of this study was to evaluate the clinical and radiological outcomes and the complications of tantalum cones in revision TKA. Hypothesis: Trabecular tantalum cones provide stable and durable metaphyseal reconstruction when used during revision TKA. Material and methods: Trabecular Metal (TM) cones (Zimmer, Warsaw, IN, USA) were used for 52 revision TKAs in 51 patients (mean age, 68 +/- 9 years) managed in two centres between 2008 and 2013. A rotating hinge prosthesis was chosen for 38 (73%) knees and a condylar constrained knee prosthesis for 14 (27%) knees, with 37 tibial and 34 femoral cones. The two most common reasons for revision surgery were aseptic loosening (n= 22, 42%) and infection (n=19, 37%). The bone loss was severe in most cases. At each centre, after a mean follow-up of 34 months (range, 24-52 months), two independent observers assessed the Knee Society Score (KSS), range of motion, mechanical axis, and osteo-integration for each patient. Results: Mean KSS increased from 46 preoperatively to 77 (P=0.001) at last follow-up and the mean KSS function from 39 to 57 (P=0.007). Mean range of motion improved from 93 degrees (45 degrees-120 degrees) to 110 (65 degrees-130 degrees) (P= 0.001). Mean postoperative mechanical axis was 180 degrees (172 degrees-190 degrees). Radiographic evaluation showed evidence of osteo-integration for all cones. Four revisions were performed for recurrence of infection but none for mechanical failure. Discussion: The findings of our study confirm the biomechanical and biological reliability of Trabecular Metal (TM) cones used to fill metaphyseal bone defects during revision TKA. Level of evidence: IV, retrospective therapeutic study. (C) 2016 Elsevier Masson SAS. All rights reserved.Show less >
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Anglais
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