Full Cementation in Revision Total Knee Arthroplasty Using a Constrained Condylar Knee Prosthesis with an Average 7-Year Follow-up

PURPOSE: To evaluate clinical and radiological outcome of the full cementation technique in revision total knee arthroplasty (TKA) using a constrained condylar knee (CCK) prosthesis. MATERIALS AND METHODS: Between January 2008 and March 2012, 18 cases (16 patients) of fully cemented revision TKA were performed using a CCK prosthesis. Fifteen cases of aseptic loosening (13 patients) and 3 cases of infection were included. There were 2 males and 14 females with a mean age of 76.7 years at the time of surgery, and the average follow-up was 81 months. Clinically, the pain score, function score and Hospital for Special Surgery (HSS) score were evaluated. Radiologically, loosening, radiolucent lines and migration of implant were evaluated. RESULTS: Preoperatively, the pain score, function score and HSS score were 50.3, 24.4 and 61.8 points, respectively. At the latest follow-up, the scores were improved to 84.8, 63.6 and 85.6 points, respectively (p < 0.05). Loosening or migration of implant was not observed in any cases. Radiolucent lines were observed in 5 cases underneath the tibial component without progression during the follow-up. CONCLUSIONS: The full cementation technique in revision TKA using a CCK showed excellent clinical results. Although radiolucent lines were observed in 27.8% underneath the tibial component, there was no progression to loosening or instability.

A CLINICAL CASE OF ALLOPLASTIC CONDYLE REPLACEMENT WITH CONDYLAR PROSTHESIS IN SEVERE DEGENERATIVE JOINT DISEASE

Fourteen Years Follow-up of Ohara Condylar Prosthesis for the Treatment of Bilateral Temporomandibular Joint Ankylosis

Temporomandibular joint(TMJ) ankylosis is a serious and disabling condition. It results in the inability of the patient to open the mouth, impairment of the speech, difficulty in mastication, poor oral hygiene, facial asymmetry, mandibular micrognathia and psychologic disability. The causes of TMJ ankylosis can be diverse, traumatic, septic, autoimmune and rarely neoplastic. Traumas and particularly mandibular condyle fracture represent the most frequent cause of TMJ ankylosis. The interposition of muscle and fascia between the bones and many other materials like cartilage, muscle and dermis, fat or fascia was suggested.1 In addition, numerous alloplastic materials have been used for partial or total reconstruction of the TMJ. The current authors report 14 years follow-up results of Ohara condylar prosthesis for the treatment of bilateral temporomandibular joint ankylosis in a 35-year-old male. The patient had a bilateral TMJ ankylosis and micrognathia resulted from rheumatoid arthritis and the TMJ reconstruction with Ohara condylar prosthesis was performed. Four years later, right Ohara prosthesis was removed due to the penetration of the prosthesis into the middle cranial fossa and right TMJ was reconstructed with vascularized calvarial bone graft and costo-chondral graft. At 13 years after the first operation, reankylosis occurred bilaterally, and gap arthroplasty with interpositional silicon block was performed. Now he is being encouraged to exercise to open the mouth and opening up to 30mm is possible.