Polyethylene spinout in the Attune® Cruciate-Retaining Rotating-Platform (CR RP) total knee arthroplasty performed with a cruciate-sacrificing and measured-resection technique
Tóm tắt
Polyethylene (PE) spinout is a known but uncommon complication when using a mobile-bearing (MB) total knee arthroplasty (TKA) design. Sacrificing the posterior cruciate ligament (PCL) is within the manufacturer’s recommendations for the Attune® Cruciate-Retaining Rotating-Platform (CR RP) knee design. To discuss the potential aetiology and prevention of spinout in the Attune® CR RP knee. We used a retrospective radiological review from two centres reporting a higher rate of spinout in the Attune® CR RP knee using a cruciate-sacrificing and measured-resection technique when compared to a gap-balancing technique. Three hundred and thirty-two patients were evaluated over a 3-year period. There were 8 out of 279 (2.86%) cases of spinout in our first cohort of patients using a measured-resection technique. There were 0 out of 53 cases of spinout in our second cohort of patients where a gap-balancing technique was used. One spinout was reduced closed, the other seven were initially revised to a thicker RP insert of the same design. Of these seven, three underwent a further revision TKA and one patient required a knee fusion/arthrodesis. This study reports a higher incidence of PE spinout in the Attune® CR RP TKA when a measured-resection technique in combination with PCL resection is performed. We recommend a gap-balancing technique with conservative soft-tissue release if the surgeon is planning to sacrifice the PCL in the Attune® CR RP.
Tài liệu tham khảo
Malinzak RA, Small SR, Rogge RD, Archer DB, Oja JW, Berend ME et al (2014) The effect of rotating platform TKA on strain distribution and torque transmission on the proximal tibia. J Arthroplast 29:541–547
Hopley CD, Crossett LS, Chen AF (2013) Long-term clinical outcomes and survivorship after total knee arthroplasty using a rotating platform knee prosthesis: a meta-analysis. J Arthroplast 28(1):68–77
Baker PN, Rushton S, Jameson SS, Reed M, Gregg P, Deehan DJ (2013) Patient satisfaction with total knee replacement cannot be predicted from pre-operative variables alone: a cohort study from the National Joint Registry for England and Wales. Bone Joint J 95-B(10):1359–1365
Bourne RB, Chesworth B, Davis A, Mahomed N, Charron K (2010 Feb) Comparing patient outcomes after THA and TKA: is there a difference? Clin Orthop Relat Res 468(2):542–546
National Joint Registry for England, Wales and Northern Ireland. 15th Annual Report, 2018. http://www.njrreports.org.uk/Portals/0/PDFdownloads/NJR%2015th%20Annual%20Report%202018.pdf. Accessed on 28 Nov 2018
Attune® knee system surgical technique guide. http://synthes.vo.llnwd.net/o16/LLNWMB8/US%20Mobile/Synthes%20North%20America/Product%20Support%20Materials/Technique%20Guides/DSUSJRC03161437%20Rev%205_ATTUNE%20Cemented%20Primary%20Knee%20Surgical%20Tech.pdf
Diamond OJ, Doran E, Beverland DE (2018) Spinout/dislocation in mobile-bearing total knee arthroplasty: a report of 26 cases. J Arthroplast 33(2):537–543
Daines BK, Dennis DA (2014) Gap balancing vs. measured resection technique in total knee arthroplasty. Clin Orthop Surg 6(1):1–8
Pagoti R, Beverland D (2017) Soft tissue balancing without ligament release in complex total knee replacement. Thieme Medical and Scientific Publishers Pvt, Belfast, Ltd ISBN: 978–93–86293-09-1
Pagoti R, O’Brien S, Doran E, Beverland D (2017) Unconstrained total knee arthroplasty in significant valgus deformity: a modified surgical technique to balance the knee and avoid instability. Knee Surg Sports Traumatol Arthrosc 25(9):2825–2834
Lebel B, Lewallen D (2010) Total knee arthroplasty dislocation: incidence, etiology, and management. J Bone Jt Surg Br 92-B(Suppl II)
Yoshiya S, Matsui N, Komistek RD, Dennis DA, Mahfouz M, Kurosaka M (2005) In vivo kinematic comparison of posterior cruciate-retaining and posterior stabilized total knee arthroplasties under passive and weight-bearing conditions. J Arthroplast 20(6):777–783
Dennis DA, Komistek RD, Kim RH, Sharma A (2010) Gap balancing versus measured resection technique for total knee arthroplasty. CORR 468(1):102–107
Katz MA, Beck TD, Silber JS, Seldes RM, Lotke PA (2001) Determining femoral rotational alignment in total knee arthroplasty: reliability of techniques. J Arthroplasty 16(3):301–305
Kim CW, Lee CR, Gwak HC, Kim JH, Kwon YU, Kim DY (2020) The effects of surgical technique in total knee arthroplasty for Varus osteoarthritic knee on the rotational alignment of femoral component: gap balancing technique versus measured resection technique. J Knee Surg 33(2):144–151
Huang T, Long Y, George D, Wang W (2017) Meta-analysis of gap balancing versus measured resection techniques in total knee arthroplasty. Bone Joint J 99-B(2):151–158
Harvey RA, Hossain M. Femoral component rotation in the Attune TKR, balanced technique and measured resection instrumentation. Poster presentation. BASK 2017
ATTUNE® CR Knee and ATTUNE® PS Knee NJR Implant Summary Report August 2018. http://synthes.vo.llnwd.net/o16/LLNWMB8/US Mobile/Synthes North America/Product Support Materials/PDF-PowerPoints/JOINT RECONSTRUCTION/092206–180822 ATTUNE® Knee Implant Summary Report Presentation Cert.pdf