Ten-Year Results of Primary and Revision Condylar-Constrained Total Knee Arthroplasty in Patients with Severe Coronal Plane Instability

Andrea Camera 1, Stefano Biggi*, 1, Gabriele Cattaneo 1, Giovanni Brusaferri 2
1 Department of Prosthetic Surgery, Santa Corona Hospital, via XXV Aprile 38, 17027 Pietra Ligure (SV), Italy
2 Clinical Affairs Department, Zimmer GmbH, Winterthur, Switzerland

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 1070
Abstract HTML Views: 338
PDF Downloads: 219
Total Views/Downloads: 1627
Unique Statistics:

Full-Text HTML Views: 523
Abstract HTML Views: 230
PDF Downloads: 161
Total Views/Downloads: 914

Creative Commons License
© Camera et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Santa Corona Hospital, via XXV Aprile 38, 17027 Pietra Ligure (SV), Italy; Tel: +393425322143; E-mail:


Objective :

To retrospectively review the results at minimum ten years after surgery of a consecutive series of total knee arthroplasties (TKAs) performed using a constrained condylar implant in patients with severe coronal plane instability.

Materials and Methods :

The series comprised of 44 patients (45 knees) who received primary (19 knees) or revision (26 knees) TKA with a constrained condylar implant between 2001 and 2003 at a single institution.

Results :

There were no revisions or any other surgery related complications at a mean implantation time of 11.0 years. In 38 patients (15 knees in the primary group and 24 knees in the revision group) who were available for clinico-radiographic follow-up at a minimum of ten years, there was no sign of radiographic loosening. Two patients showed cortical hypertrophy at the extension stem tip but none complained of pain around the stem tip.

According to the TLKSS score grading, 73% of the patients in the primary group had results categorized as good or excellent, while 54% of the patients in the revision group had fair results. Four patients (one (7%) in the primary group and three (13%) in the revision group) had poor results. The median WOMAC Index was 80.2% (interquartile range: 74.0% - 81.2%) and 74.0% (interquartile range: 72.1% - 75.8%) in the primary and in the revision groups, respectively (p=0.010).

Conclusion :

This study showed satisfactory clinical outcomes with no re-operations at minimum ten years after implantation in patients who had undergone primary or revision TKA with a condylar constrained implant.

Keywords: Condylar constrain, Coronal plane instability, Primary total knee arthroplasty, Revision total knee arthroplasty, TLKSS, Varus-valgus constrain, WOMAC.