Long-term results of the Scorpio posterior-stabilized total knee arthroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate long-term result of Scorpio posterior-stabilized total knee arthroplasty.</p><p><b>METHODS</b>There were 160 patients (240 knees) underwent Scorpio posterior-stabilized total knee arthroplasty between December 1998 and December 2000, which were performed by the same surgeon. Patients were followed up from June 2013 to December 2013. Knee Society Scoring (KSS), Hospital for Special Surgery (HSS) patellofemoral scoring, standard weight-bearing anteroposterior and patellar tangential radiographs were assessed. Satisfaction of outcome was requested. Alignment of components and presence of radiolucent lines were assessed by the radiographic scoring system of knee society. Paired t-test was used compared to the data between preoperation and the time of last follow-up.</p><p><b>RESULTS</b>Ninety-five patients (141 knees) (59.4%) were followed up. Average follow-up duration was 13.3 years (range 12 to 15 years). Eight knees were revised due to periprosthetic infection (4 knees), aseptic loosening of tibial tray (3 knees) and wear-out of polyethylene insert (1 knee). Compared with preoperative ones, KSS knee score, KSS functional score and range of motion improved significantly (pre-operation: 26±16, 34±18, 87°±25°; follow-up time: 93±8, 78±27, 114°±22°) (t=45.55, 15.60, 13.03, all P<0.01). In terms of KSS knee score and HSS patellofemoral score, 106 knees were rated as excellence respectively. Ninety-five knees had satisfaction with outcome for maximum. The presences of radiolucent lines occurred around 5 femoral and 11 tibial components with range less than 2 mm. The survival rate at 10 years was 94.5% with revision for any reason as the end point.</p><p><b>CONCLUSION</b>The long-term study indicates that Scorpio posterior-stabilized knee system shows favorable clinical and radiological results.</p>

The mid-term follow-up of revision total knee athroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the mid-term follow-up results of revision of total knee arthroplasty and compare the different strategies for infective revisions.</p><p><b>METHODS</b>All of 45 patients (47 operated knees) lived in Beijing were treated from April 1989 to October 2010 in Arthritis Clinic and Research Center, Peking University People's Hospital. There were 6 male and 39 female patients, who aged from 31 to 77 years (mean (62 ± 11) years). The function of knee, satisfaction and imaging then were compared retrospectively. American Knee Society Scores (KSS), Western Ontario & McMaster University Osteoarthritis Index (WOMAC), the medical outcomes study item short form health survey (SF-36) scales and satisfaction/pain visual analogue scales (VAS) of patients were evaluated. The patients were divided into infection group (33 patients, 34 knees) and non-infection group (12 patients, 12 knees) according to the indication of revision of total knee arthroplasty and compared by t-tests.</p><p><b>RESULTS</b>The time from operation to follow-up was 1 year and 2 months to 17 years. The mid-term follow-up time was 8 years 3 months. There were significant improvements of KSS clinical and function scores (from 66.9 ± 28.0 and 44.4 ± 37.6 to 25.4 ± 24.2 and 10.0 ± 24.8, t = 7.043 and 3.797, both P = 0.001). Patients of infection group had lower KSS clinical and function scores than non-infection group before operation, and lower Society Function (t = 2.225, 3.520 and 2.885, P = 0.035, 0.002 and 0.007). About the septic group, the II-stage group had significant better post-operation KSS function scores, Society Function, physical component summary, WOMAC functional score and WOMAC score than I-stage group (t = 2.160-3.268, P = 0.004-0.042). The 1-year, 2-year, 6-year, 17-year survival rate were 83.6%, 78.7%, 62.1%, 44.5%.</p><p><b>CONCLUSIONS</b>Revision total knee arthroplasty is an effective method for solving the failure of primary total knee arthroplasty. It can improve the pain and activity difficulty following the failure of primary total knee arthroplasty, and partially improve function along with quality of life. The results of non-infection group are better than infection group. There may be better results for II-stage revision total knee arthroplasty than I-stage revision. Both I-stage and II-stage revision total knee arthroplasty are effective.</p>