engleski

Revision total knee arthroplasty with modular endoprosthesis

Aims: Revision total knee arthroplasties are performed with increasing frequency due to the increasing numbers of primary arthroplasties. The aim of the paper is to retrospectively analyze implantation of revision total knee arthroplasties, endoprosthesis model Kinemax Plus Superstabilizer at the Department of Orthopedic Surgery University of Zagreb. Material and methods: Between May 2000 and December 2003 implantation of 37 endoprosthesis model Kinemax Plus Superstabilizer was preformed in our Department. The mean patient follow-up was 27, 3± 11, 7 months. Patients' sex distribution was 33 women and 4 men. The mean age of the patients was 68, 4± 7, 3 years. In 12 patients knee revision arthroplasty was performed as primary total knee replacement. Severe deformities and bone loss was found in 9 of those patients, two patients had corrective osteotomy of distal femur prior knee revision endoprosthesis implantation, and one had prior implantation of unicondylar endoprosthesis. Prior implantation of the primary total knee endoprosthesis was found in 25 patients. The indications for revision knee arthroplasty included pain and aseptic instability in 22 patients, and septic instability of the knee endoprosthesis in three patients, treated with two-stage revision arthroplasty. Results: The mean time from primary knee arthroplasty to knee revision arthroplasty was 8, 9± 4, 6 years (range, 2 to 16). In none of 37 patients clinical and/or x-ray signs of instability of revision endoprosthesis were found during follow-up period. We detected early postoperative complications in six patients: four patients had haematoma ; one patient had patella luxation and later deep joint infection, treated successfully with debridement ; and one patient needed tibial insert replacement because of knee instability. Conclusion: Although the revision of total knee replacements is known to be demanding procedure, our analysis of revision total knee arthroplasty shows good results. The survival of knee revision endoprosthesis Kinemax Plus Superstabilizer is satisfactory. General conclusion is that modular type of the revision endoprosthesis allows solving main problems of complex revision arthroplasty of the knee joint.

revision total knee arthroplasty; modular endoprosthesis

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