Varus-valgus constrained insert with posterior-stabilized femoral components in complex primary total knee arthroplasties

Aims: Varus-valgus constrained (VVC) devices are typically used in revision settings, often with stems to mitigate the risk of aseptic loosening. However, in at least one system, the VVC insert is compatible with the primary posterior-stabilized (PS) femoral component, which may be an option in comp...

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Autores principales:	Afton K. Limberg, Cody C. Wyles, Michael J. Taunton, Arlen D. Hanssen, Mark W. Pagnano, Matthew P. Abdel
Formato:	article
Lenguaje:	EN
Publicado:	The British Editorial Society of Bone & Joint Surgery 2021
Materias:	varus-valgus constraint (vvc) posterior-stabilized (ps) primary total knee arthroplasty (tka) stems instability femoral components primary total knee arthroplasties valgus deformity aseptic loosening femora reoperation clinical outcomes knee society scores tkas radiolucent lines Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/d01b4d3564084b759256de3c1ac3919f
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spelling	oai:doaj.org-article:d01b4d3564084b759256de3c1ac3919f2021-12-01T18:44:47ZVarus-valgus constrained insert with posterior-stabilized femoral components in complex primary total knee arthroplasties2633-146210.1302/2633-1462.211.BJO-2021-0134.R1https://doaj.org/article/d01b4d3564084b759256de3c1ac3919f2021-11-01T00:00:00Zhttps://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.211.BJO-2021-0134.R1https://doaj.org/toc/2633-1462Aims: Varus-valgus constrained (VVC) devices are typically used in revision settings, often with stems to mitigate the risk of aseptic loosening. However, in at least one system, the VVC insert is compatible with the primary posterior-stabilized (PS) femoral component, which may be an option in complex primary situations. We sought to determine the implant survivorship, radiological and clinical outcomes, and complications when this VVC insert was coupled with a PS femur without stems in complex primary total knee arthroplasties (TKAs). Methods: Through our institution’s total joint registry, we identified 113 primary TKAs (103 patients) performed between 2007 and 2017 in which a VVC insert was coupled with a standard cemented PS femur without stems. Mean age was 68 years (SD 10), mean BMI was 32 kg/m2 (SD 7), and 59 patients (50%) were male. Mean follow-up was four years (2 to 10). Results: The five-year survivorship free from aseptic loosening was 100%. The five-year survivorship free from any revision was 99%, with the only revision performed for infection. The five-year survivorship free from reoperation was 93%. The most common reoperation was treatment for infection (n = 4; 4%), followed by manipulation under anaesthesia (MUA; n = 2; 2%). Survivorship free from any complication at five years was 90%, with superficial wound infection as the most frequent (n = 4; 4%). At most recent follow-up, two TKAs had non-progressive radiolucent lines about both the tibial and femoral components. Knee Society Scores improved from 53 preoperatively to 88 at latest follow-up (p < 0.001). Conclusion: For complex primary TKA in occasional situations, coupling a VVC insert with a standard PS femur without stems proved reliable and durable at five years. Longer-term follow-up is required before recommending this technique more broadly. Cite this article: Bone Jt Open 2021;2(11):921–925.Afton K. LimbergCody C. WylesMichael J. TauntonArlen D. HanssenMark W. PagnanoMatthew P. AbdelThe British Editorial Society of Bone & Joint Surgeryarticlevarus-valgus constraint (vvc)posterior-stabilized (ps)primary total knee arthroplasty (tka)stemsinstabilityfemoral componentsprimary total knee arthroplastiesvalgus deformityaseptic looseningfemorareoperationclinical outcomesknee society scorestkasradiolucent linesOrthopedic surgeryRD701-811ENBone & Joint Open, Vol 2, Iss 11, Pp 921-925 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	varus-valgus constraint (vvc) posterior-stabilized (ps) primary total knee arthroplasty (tka) stems instability femoral components primary total knee arthroplasties valgus deformity aseptic loosening femora reoperation clinical outcomes knee society scores tkas radiolucent lines Orthopedic surgery RD701-811
spellingShingle	varus-valgus constraint (vvc) posterior-stabilized (ps) primary total knee arthroplasty (tka) stems instability femoral components primary total knee arthroplasties valgus deformity aseptic loosening femora reoperation clinical outcomes knee society scores tkas radiolucent lines Orthopedic surgery RD701-811 Afton K. Limberg Cody C. Wyles Michael J. Taunton Arlen D. Hanssen Mark W. Pagnano Matthew P. Abdel Varus-valgus constrained insert with posterior-stabilized femoral components in complex primary total knee arthroplasties
description	Aims: Varus-valgus constrained (VVC) devices are typically used in revision settings, often with stems to mitigate the risk of aseptic loosening. However, in at least one system, the VVC insert is compatible with the primary posterior-stabilized (PS) femoral component, which may be an option in complex primary situations. We sought to determine the implant survivorship, radiological and clinical outcomes, and complications when this VVC insert was coupled with a PS femur without stems in complex primary total knee arthroplasties (TKAs). Methods: Through our institution’s total joint registry, we identified 113 primary TKAs (103 patients) performed between 2007 and 2017 in which a VVC insert was coupled with a standard cemented PS femur without stems. Mean age was 68 years (SD 10), mean BMI was 32 kg/m2 (SD 7), and 59 patients (50%) were male. Mean follow-up was four years (2 to 10). Results: The five-year survivorship free from aseptic loosening was 100%. The five-year survivorship free from any revision was 99%, with the only revision performed for infection. The five-year survivorship free from reoperation was 93%. The most common reoperation was treatment for infection (n = 4; 4%), followed by manipulation under anaesthesia (MUA; n = 2; 2%). Survivorship free from any complication at five years was 90%, with superficial wound infection as the most frequent (n = 4; 4%). At most recent follow-up, two TKAs had non-progressive radiolucent lines about both the tibial and femoral components. Knee Society Scores improved from 53 preoperatively to 88 at latest follow-up (p < 0.001). Conclusion: For complex primary TKA in occasional situations, coupling a VVC insert with a standard PS femur without stems proved reliable and durable at five years. Longer-term follow-up is required before recommending this technique more broadly. Cite this article: Bone Jt Open 2021;2(11):921–925.
format	article
author	Afton K. Limberg Cody C. Wyles Michael J. Taunton Arlen D. Hanssen Mark W. Pagnano Matthew P. Abdel
author_facet	Afton K. Limberg Cody C. Wyles Michael J. Taunton Arlen D. Hanssen Mark W. Pagnano Matthew P. Abdel
author_sort	Afton K. Limberg
title	Varus-valgus constrained insert with posterior-stabilized femoral components in complex primary total knee arthroplasties
title_short	Varus-valgus constrained insert with posterior-stabilized femoral components in complex primary total knee arthroplasties
title_full	Varus-valgus constrained insert with posterior-stabilized femoral components in complex primary total knee arthroplasties
title_fullStr	Varus-valgus constrained insert with posterior-stabilized femoral components in complex primary total knee arthroplasties
title_full_unstemmed	Varus-valgus constrained insert with posterior-stabilized femoral components in complex primary total knee arthroplasties
title_sort	varus-valgus constrained insert with posterior-stabilized femoral components in complex primary total knee arthroplasties
publisher	The British Editorial Society of Bone & Joint Surgery
publishDate	2021
url	https://doaj.org/article/d01b4d3564084b759256de3c1ac3919f
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Varus-valgus constrained insert with posterior-stabilized femoral components in complex primary total knee arthroplasties

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