engleski

Total knee arthroplasty with modular endoprothesis

Aims: Modular knee endoprothesis are used for revision total knee arthroplasties and occasionally for primary arthroplasties in severely deformed knees. The aim of the paper is to retrospectively analyze placement of modular knee endoprothesis at the Department of Orthopaedic Surgery University of Zagreb. Material and methods: Between May 2000 and December 2007 implantation of 78 modular endoprothesis in 74 patients was performed by 5 surgeons in our Department. Patient’ s gender distribution was 58 women and 16 men. The average age of patients at time of surgery was 68.5 years (from 46 till 87). In 15 patients with severe deformities and bone loss modular endoprothesis was placed as primary total knee placement. Modular knee endoprothesis was used for revision arthroplasty in 63 cases. The indications for revision knee arthroplasty included pain and aseptic instability 57 patients and, septic instability of the knee endoprothesis in 6 patients, treated with two- stage revision arthroplasty. Results: The mean time from previous knee arthroplasty to knee revision arthroplasty was 6.54 years (range, 1 to 21). The average duration of one stage total knee endoprothesis replacement was 144 minutes (from 90 till 240 minutes) with average intraoperative blood loss of 484 ml (range, 100 till 2000 ml). Postoperative complications were detected in 14 patients: six patients had haematoma needed surgical evacuation ; four patients had deep joint infection, and four had superficial infection from which one was in the inguinal region because of skin damage from Eschmarch bandage. There was one patella luxation and one patella fracture second postoperative day after patient’ s fall. In one patient tibial insert was replaced because of knee instability. Conclusion: The placement of modular knee endoprothesis is demanding surgical procedure as it is used for complicated cases such as revision knee arthroplasties and severe knee deformities. As such it is characterized with higher incidence of early complications, but it still provides us a good solution for those patients.

knee ; modular endoprosthesis ; revision

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