RESEARCH ARTICLE


Good Early Results Obtained with a Guided-Motion Implant for Total Knee Arthroplasty: A Consecutive Case Series



Hagen Hommel*, Kai Wilke
Krankenhaus Märkisch Oderland GmbH BT Wriezen, Klinik für Orthopädie, Sportmedizin und Rehabilitation, Wriezen, Germany.


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© 2017 Hommel and Wilke

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Krankenhaus Märkisch Oderland GmbH, Sonnenburger Weg 3, 16269 Wriezen, Germany; Tel: +49 33456 - 40401; Fax: +49 33456 - 40402; E-mail: H.Hommel@khmol.de


Abstract

Background:

Previous studies have shown a high incidence of complications with a bi-cruciate stabilized (BCS) guided-motion total knee arthroplasty (TKA) design, which led to recent modifications of the design by the manufacturer.

Objective:

The current study was undertaken to assess whether the use of this TKA system with an extension-first surgical technique is associated with a similar rate of short-term adverse outcome as reported in literature.

Material and Methods:

This retrospective study enrolled 257 consecutive patients (257 knees) undergoing TKA for osteoarthritis of the knee, with the first 153 receiving cemented Journey BCS I implants and the remaining 104 receiving cemented Journey BCS II implants when these became available.

Results:

Mean follow-up time for the cohort was 24.5 ± 7.8 months (range, 12 - 36 months). There were no cases of stiffness. Incidence of iliotibial friction syndrome was considered low: three (2.0%) knees in the BCS I group and two (1.9%) in the BCS II group (p = 0.676). Five (2.5%) knees presented with mild instability in midflexion, three (2.0%) in the BCS I group and two (1.9%) in the BCS II group (p = 0.676). One patient with a BCS I implant required reoperation for aseptic loosening 23 months postoperatively. At one-year follow-up, there were no clinically relevant differences in any of the clinical outcomes.

Conclusion:

When used in combination with an extension-first surgical technique, good early functional results with an acceptable rate of complications were obtained with both the original and the updated Journey BCS knee implant.

Keywords: Osteoarthritis, Knee, Arthroplasty, Knee replacement, Gap-balancing, Extension-first technique, Balancer device, Outcome assessment.