Abstract
Objective: To assess the early results of the TC3 knee prosthesis, a modular system with stems and augments, in difficult primary and revision knee arthroplasties.
Method: 13 index procedures were undertaken for gross varus or valgus deformities with severe ligamentous incompetence and/or major bone defects. 18 procedures were revision arthroplasties, 7 being undertaken for sepsis.
28 knees underwent full clinical and radiological review at a mean of 25.8 months post-operatively, using the Hospital for Special Surgery Score and the Knee Society Score. 2 patients were interviewed by phone with recent radiological follow-up. One patient had died from unrelated causes.
Results: All patients were very pleased with the outcome of surgery.
The mean pre-operative alignment for the primary arthroplasties was 28° for the varus and 32° for the valgus knees. The mean postoperative alignment was 7°. The mean Hospital for Special Surgery score was 72.4 for primary arthroplasties and 72.7 for revision surgery. The mean Knee Society Knee Score was 79.8 and 75.1 respectively, and the mean Functional Score was 60.8 and 49.4 respectively. The latter reflects the elderly age, multiple joint involvement and constitutional status (including rheumatoid arthritis) of many of these patients. 4 patients experienced retropatellar pain. One patient with severe rheumatoid developed sepsis of the revision implant.
Difficulties with tibial tray lateralisation and stem fixation will be discussed.
Conclusion: The TC3 knee system affords an excellent modular option to compensate for bone defects and ligamentous incompetence, achieving restoration of the joint line and satisfactory function.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
