Abstract
Introduction:
Proper component orientation and soft tissue balancing are essential for longevity of total knee arthroplasty (TKA), especially in young and active patients. The aim of this study was to evaluate long-term results and quality of TKA in young and active patients with extension first gap balancing technique, in 2 Posterior-Stabilized (PS) total knee designs with identical femoral component.
Material and Methods:
43 consecutive Rotating-Platform (RP-PS, 33 patients) and 38 Fixed-Bearing (FB-PS, 29 patients) with University of California Los Angeles (UCLA) activity score of 5 or above and mean age was 53 ± 1.5 years were followed prospectively for a minimum of 10 years. 18 random TKAs were analyzed for component rotation using MRI.
Results:
The majority of patients (77%, 24 patients in RP-PS and 65%, 25 patients in FB-PS) were still participating in recreational activities at final follow-up. There was no case of early or late mid flexion instability causing spinout. There was no malalignment or patellofemoral maltracking. Non-progressive radiolucency was seen at the tibial zone 1 in one of the RP-PS and 3 of the FB-PS knees. The mean femoral rotation was 2 and 3 degrees of external in relation to the transepicondylar axis in RP-PS and in FB-PS, respectively.
Two patients in the FB-PS were revised (one for per-prosthetic fracture and one for osteolysis and loosening). There were no revisions in the RP-PS group. Kaplan-Meier survivorship at 10 years was 100% in RP-PS and 97% in FB-PS.
Discussion and Conclusions:
Extension first gap balancing technique is a safe, accurate, and reproducible with excellent alignment and long-term durability and high quality of function in young, active patients.
