Use of Femoral Augments Provides Greater Functional Outcomes Than Femoral Augments With Offset Adapters
mag(2013)
摘要
Introduction: Revision total knee arthroplasty (TKA) can be very complex in nature with difficulties/obstacles involving bone and soft tissue deficits, visualization and exposure, as well as alignment and fixation. Auxiliary devices such as augmentation and offset adapters help address these issues; however they increase the complexity of the reconstruction. The objective of this study was to show that use of a single radius revision TKA system allowing for minimal auxiliary revision devices can yield positive early clinical outcomes. Methods: This data was collected as part of a prospective, post-market, multicenter study. One hundred and twenty-five single radius revision TKA cases were evaluated. Surgical details were reviewed and cases were grouped based on type of auxiliary devices used. Group 1 included cases that used only femoral and/or tibial augments. Group 2 used femoral and/or tibial augments in conjunction with femoral and/or tibial offset adapters. Early clinical outcomes, operative data and radiographic findings were used to compare cases. Results: At 6 weeks and 1 year postoperatively, Knee Society Scores, pain, function and quality of life all improved more in Group 1 (augments only) than Group 2 (augments and offset adapters). There was no difference in range of motion postoperatively for either group. Preoperative demographics showed no differences between Group 1 and Group 2. Offset adapters were used in only 17.6% of the cases. Discussion/Conclusion: Studies have discussed the increase in complexity of revision TKAs is associated with a decrease in patient outcomes. The surgical technique for revision TKAs can be more difficult due to an increase in bone loss and anatomical changes. Augment usage is the main auxiliary component utilized to supplement bone loss. By design, this single radius revision system limits the additional need for offset adapters to adjust patient alignment, while achieving excellent postoperative patient outcomes. Reducing the amount of devices needed for reconstruction decreases the intraoperative complexity and has shown improved functional outcomes with this single radius revision TKA system.
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关键词
femoral augments,greater functional outcomes
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