Abstract
Introduction: Common failure modes of revision total knee arthroplasty (TKA) include aseptic component loosening and damage to constraining mechanisms which are often required in revision TKA. Mobile-bearing (MB) revision TKA components have been developed in hopes of lessening these failure mechanisms. Our objective was to evaluate the early clinical outcomes for the use of MB in revision TKA with a minimum 2-year follow-up and to evaluate bearing complications.
Methods: Retrospective clinical and radiographic evaluation of 84 MB revision TKAs with minimum 2-year follow-up was performed. Revision TKAs were performed using PFC Sigma and LCS revision rotating platform implants (Depuy, Warsaw, IN).
Indications for revision include aseptic loosening (31 knees), instability (30 knees), failed unicompartmental knee replacement (8 knees), infection reimplantation (7 knees), arthrofibrosis (3 knees), chronic hemarthrosis (3 knees), failed patellofemoral replacements (1 knees), and nonunion of a supracondylar femur fracture (1 knee).
Results: At a mean follow-up of 3.7 years, the average Knee Society clinical and function scores had increased from 50.3 points preoperatively to 89.1 points and from 49.3 points to 80.1 points, respectively. Average motion improved from 99.8° preoperatively to 116.5° postoperatively. Radiographic review demonstrated excellent fixation with no evidence of component loosening upon latest follow-up. No cases of bearing instability were observed.
Conclusion: This evaluation of 84 MB revision TKAs has demonstrated favorable early results at a mean follow-up of 3.7 years with no occurrence of bearing instability. Longer follow-up is required to evaluate for potential advantages of reducing polyethylene wear, lessening fixation stresses, and protection of constraining mechanisms.
Correspondence should be addressed to Diane Przepiorski at ISTA, PO Box 6564, Auburn, CA 95604, USA. Phone: +1 916-454-9884; Fax: +1 916-454-9882; E-mail: ista@pacbell.net