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. 2018 Jun 26;19(1):205.
doi: 10.1186/s12891-018-2128-1.

A prospective evaluation of a largely cementless total knee arthroplasty cohort without patellar resurfacing: 10-year outcomes and survivorship

Richard J Napier  1 , Christopher O'Neill  2 , Seamus O'Brien  2 , Emer Doran  2 , Brian Mockford  2 , Jens Boldt  3 , David E Beverland  2
Affiliations

A prospective evaluation of a largely cementless total knee arthroplasty cohort without patellar resurfacing: 10-year outcomes and survivorship

Richard J Napier et al. BMC Musculoskelet Disord. .

Abstract

Background: The theoretical benefits of a mobile bearing design in Total Knee Arthroplasty (TKA) include increased articular surface conformity with a reduction in both polyethylene wear and implant interface shear. However, to date these theoretical advantages have not been translated into published evidence of superior survivorship. This paper presents the results of a prospective, non-comparative study evaluating the performance of the mobile bearing Low Contact Stress LCS Complete Rotating Platform TKA in a largely cementless cohort without patellar resurfacing.

Methods: 237 consecutive patients (240 knees) undergoing primary TKA were prospectively recruited. All received the LCS Complete Rotating Platform TKA (DePuy International, Leeds, UK). Clinical and radiographic assessments were performed at 3, 12, 60 and 120 months post-operatively. Radiographic evaluation was performed by an independent external surgeon.

Results: The mean age was 70.3 years. 77.5% of cases were cementless. Radiographic assessment suggested excellent femoral component fixation. 22 tibial radiolucent lines (RLLs) > 1 mm were observed in 12 knees. No RLLs were progressive. There have been two revisions; one for late infection and one for aseptic loosening. No patients underwent secondary patellar resurfacing. The cumulative implant survivorship, using component revision for any reason as the endpoint, was 98.9% (95% CI, 95.6 to 99.7%) at 10 years.

Conclusions: The excellent survivorship at a minimum 10-year follow-up supports the use of uncemented porous coated fixation without patellar resurfacing with the non-posterior stabilized LCS Complete Rotating Platform TKA.

Keywords: Cementless TKA; Cementless knee survivorship; Knee replacement; LCS total knee.

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Conflict of interest statement

Ethics approval and consent to participate

Institutional Review Board (IRB) approval was obtained in writing from the Office for Research Ethics Committees Northern Ireland (ORECNI). (Study reference ORECNI-335-01). Written consent was obtained from all study patients.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Demonstrating the technique for patellar contouring with an inset showing preoperative and three-month skyline views
Fig. 2
Fig. 2
Modified scoring system with femoral (1–4) and tibial (5–10) zones
Fig. 3
Fig. 3
Example of RLLs in Zones 5 & 7
Fig. 4
Fig. 4
Example of RLLs in Zone 8
Fig. 5
Fig. 5
Survival estimate at 10 years in 98.9% (95% Confidence Interval: 95.6–99.7%)
See this image and copyright information in PMC

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