Midterm results of a new personalized knee implant for total knee arthroplasty: implant survivorship and patient-reported outcome after five years' follow-up.

PURPOSE: The Persona® system is a newly launched implant designed for total knee arthroplasty (TKA) with technical innovations intended for a better functional outcome and higher flexion range. The aim of this study is to evaluate midterm outcomes and survivorship of a cohort of patients with a minimum of 5-year follow-up and to confirm previous results described in the literature. METHODS: A cohort of 91 knees (85 patients) that underwent a patella-preserving TKA with the Persona® implant and who were followed for a mean of 5.9 years' period was included in the study. Functional values were measured: Oxford Knee Score (OKS), Knee Society Knee score (KSKS) and Knee Society Function score (KSFS). Range of movement (ROM), lower limb axis correction, mobilization and complications were also registered at the last follow-up and underwent statistical analysis. RESULTS: We found a low rate of complications or radiological changes with an implant-related revision rate of 2.19%. Mean results for PROMS were 44.21 ± 4 in OKS, 90.94 ± 2.4 in KSS and 97.88 ± 9.6 in KSFS. Mean postoperative ROM was 120.8º ± 12.37º. There was no change in implant positions at the final follow-up. We found radiolucent lines in 3 knees (3.29%). CONCLUSION: At a mean follow-up of 5.9 years, the implant-related cumulative percentage revision rate was 3.3% (2 of 91) at a mean follow-up of 5.9 years, with good clinical and functional results.

Floating clavicle after a high velocity biking accident: A case report of an acromioclavicular dislocation with simultaneous proximal clavicle fracture managed surgically.

INTRODUCTION: Clavicle fractures and acromioclavicular joint dislocations are very common injuries. However, the combination of both, known as "floating clavicle" is extremely rare, with approximately 40 cases reported. PRESENTATION OF CASE: We report a case of a healthy 51-year-old male who suffered a high-velocity biking accident, with a bipolar clavicle injury (type IV acromioclavicular joint dislocation and proximal clavicle fracture), with concomitant rib fractures and pulmonary contusion. He received early surgical treatment by open reduction and osteosynthesis of the proximal clavicle (distal ulna plate, Protean®) and open reduction and stabilization with a MINAR® implant for the acromioclavicular joint. After an initial one-month immobilization, he started physical therapy. In the 10-month follow-up he presented with a pain-free full range of motion, a good cosmetic result, and radiological consolidation. DISCUSSION: Bipolar clavicle injury is a rare clinical entity that encompasses a spectrum of combined clavicle fractures, acromioclavicular or sternoclavicular joint dislocations. They are sustained in a high-energy context, and accompanying injuries must be sought. Diagnosis is made through X-Ray and CT. Despite the lack of clinical guidelines, most authors agree on surgical management of at least one of the injuries, with multiple surgical techniques available. There is an emphasis in surgical treatment of the young and active patient. Conservative treatment is associated with poorer results. CONCLUSION: It is advisable to have a high index of suspicion for floating clavicle in a high-energy trauma patient, given possible life-threatening injuries, and long-term shoulder sequelae. Surgery should be considered in a young and active patient.