Analyse de survie prospective européenne d’une prothèse totale primaire du genou asymétrique - 26/10/10
, G. Blatter b, J.-P. Canciani c, D.L. Jones d, P. Laffargue e, H.W. Neumann f, G. Pap f, C. Perka g, M.J. Sutcliff d, H. Zippel gthe European Natural Knee Group (TM)
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Summary |
Purpose of the study |
This multicentre prospective study objective is to provide mid-term results and ten-year survival analysis of the original Natural Knee-I (NK-I) system as experienced by a group of surgeons performing, within various settings, primary total knee replacement (TKR) in the general population.
Hypothesis |
The mid-term experience with this TKR system in the hands of independent surgical teams can duplicate the satisfaction level that was already published by the designer’s group itself.
Patient and method |
Two hundred and sixty-three primary TKR were performed by seven surgical teams (37 surgeons) and prospectively evaluated in four European countries. Mean age of the 263 patients (sex ratio, 2.7 females/one male) was 69 years (range, 35–92) and diagnosis was primary osteoarthritis in 85%. For the 247 TKR with complete operative data, approach was sub-vastus in 59%, posterior cruciate ligament was spared in 78%, patella was resurfaced in 56%, and 79% of reconstructions were totally cement-free. Fixation mode was only depending on the surgeon’s choice.
Results |
At 76 months average follow-up (range 24 – 190 months), modified Hospital for Special Surgery knee mean score improved from 48 points preoperatively to 83 points. Four reoperations and five revision procedures were required for eight knees. Over the 14-year survey period, the overall revision rate burden was 2% and revision rate per 100 observed component/year, 0.32. At ten years, survivorship (with revision for aseptic loosening as its end-point [two fully cementless knees]) was 98.6%.
Discussion |
Both this multicentre study and data drawn from national registers provided outcomes with equivalent level of satisfaction at equivalent follow-up to those reported by the NK-I prosthesis designer. There was no significant difference between revision rates of cemented, hybrid or cementless reconstructions.
Conclusion |
In non-designer orthopaedists’ hands, the NK-I system™, either with cemented or cementless fixation, provided satisfying mid-term results as normally expected in primary TKR with such a modern modular prosthesis.
Level of evidence |
Level IV, prospective study.
Le texte complet de cet article est disponible en PDF.Keywords : Total knee replacement, Asymmetric base-plate, Cementless fixation
Plan
 | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology : Surgery & Research sur Science Direct (www.sciencedirect.com/) en utilisant le DOI ci-dessus. |
Vol 96 - N° 7
P. 838-839 - novembre 2010 Retour au numéro
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