In recent years, the use of modern cementless implants in total knee arthroplasty has been increasing in popularity. These implants take advantage of new technologies such as additive manufacturing and potentially provide a promising alternative to cemented implant designs. The purpose of this study was to compare implant migration and tibiofemoral contact kinematics of a cementless primary total knee arthroplasty (TKA) implanted using either a gap balancing (GB) or measured resection (MR) surgical technique. Thirty-nine patients undergoing unilateral TKA were recruited and assigned based on surgeon referral to an arthroplasty surgeon who utilizes either a GB (n = 19) or a MR (n = 20) surgical technique. All patients received an identical fixed-bearing, cruciate-retaining beaded peri-apatite coated cementless femoral component and a pegged highly porous cementless tibial baseplate with a condylar stabilizing tibial insert. Patients underwent a baseline radiostereometric analysis (RSA) exam at two weeks post-operation, with follow-up visits at six weeks, three months, six months, and one year post-operation. Migration including maximum total point motion (MTPM) of the femoral and tibial components was calculated over time. At the one year visit patients also underwent a kinematic exam using the RSA system.Background
Methods
We evaluated the long-term outcome of isolated endoscopically-assisted posterior cruciate ligament reconstruction in 26 patients using hamstring tendon autografts after failure of conservative management. At ten years after surgery the mean International Knee Documentation Committee subjective knee score was 87 ( At ten years endoscopic reconstruction of the posterior cruciate ligament with hamstring tendon autograft is effective in reducing knee symptoms. Of the series, 22 patients underwent radiological assessment for the development of osteoarthritis using the Kellgren-Lawrence grading scale. In four patients, grade 2 changes with loss of joint space was observed and another four patients showed osteophyte formation with moderate joint space narrowing (grade 3). These findings compared favourably with non-operatively managed injuries of the posterior cruciate ligament. This procedure for symptomatic patients with posterior cruciate ligament laxity who have failed conservative management offers good results.
