EFFECTIVENESS OF UC ULTRA-CONGRUENT ROTATING PLATFORM PROSTHESIS IN TREATMENT OF KNEE OSTEOARTHRITIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUOShaochuan ¹ ,  WANGHaibin ² , ZHOUChi ² , CHENQunqun ³ , DONGLujue ⁴ , TANGHongyu ² , GUOCheng ⁴ , CHENJianfa ² , LIUYong ⁴

1. The Third Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China;
2. Department of Joint Surgery, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine;
3. Department of Joint Surgery, the Affiliated Hospital of Orthopedics and Traumatology, Guangzhou University of Traditional Chinese Medicine;
4. the First Clinical Medical College of Guangzhou University of Traditional Chinese Medicine;

Corresponding author：

WANGHaibin, Email: hipman@163.com

Keywords：

Osteoarthritis; Total knee arthroplasty; Knee prosthesis; Fixed-bearing prosthesis; Mobile-bearing prosthesis

DOI：

10.7507/1002-1892.20150290

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Objective To explore the effectiveness of UC ultra-congruent rotating platform prosthesis in the treatment of knee osteoarthritis by comparing with fixed-bearing implant. Methods The clinical data were retrospectively analyzed, from 98 patients (98 knees) with knee osteoarthritis undergoing primary total knee arthroplasty between January 2011 and December 2012. The UC ultra-congruent rotating platform prosthesis was used in 56 cases (mobile-bearing group) and fixed-bearing implant was used in 42 cases (fixed-bearing group). There was no significant difference in gender, age, side, weight, disease duration, grading of arthritis, the number of varus and valgus malformation, preoperative range of motion of the knee, the Knee Society Score (KSS) score, the visual analogue scale (VAS) score, femorotibial angle, tibial angle, and articular surface angle between 2 groups (P>0.05). The operation time (including anesthetic time), intraoperative blood loss, hospitalization time, total hospitalization expenses, postoperative range of motion of the knee, the KSS score, and the VAS score were compared. The femorotibial angle, tibial angle, and articular surface angle were measured on the basis of anteroposterior and lateral X-ray films, and prosthesis loosening was observed. Results There was no significant difference in the operation time, intraoperative blood loss, and hospitalization time between 2 groups (P>0.05), while the total hospitalization expenses of fixed-bearing group were significantly lower than those of the mobile-bearing group (t=8.506, P=0.000). The patients were followed up 16-30 months in the mobile-bearing group, and for 16-38 months in the fixed-bearing group. Postoperative complications occurred in 3 cases (7.14%) of the fixed-bearing group (1 case of fat liquefaction of incision, 1 case of joint stiff, and 1 case of anterior knee pain), and in 3 cases (5.36%) of the mobile-bearing group (1 case of delayed wound healing, and 2 cases of anterior knee pain); there was no significant difference in the complication rate between 2 groups (χ²=0.133, P=0.516). At last follow-up, the KSS score, VAS score, range of motion of the knee, femorotibial angle, tibial angle, and articular surface angle were superior significantly to those before operation in both groups (P<0.05), but no significant difference was found between 2 groups (P>0.05). No radiographic signs of radiolucent line, prosthetic dislocation, patellar dislocation, prosthetic loosening, and fracture was found. Conclusion UC ultra-congruent rotating platform prosthesis in the treatment of knee osteoarthritis can effectively improve the knee joint function and relief pain, which has the same short-term effectiveness to fixed-bearing implant.

Citation： HUOShaochuan, WANGHaibin, ZHOUChi, CHENQunqun, DONGLujue, TANGHongyu, GUOCheng, CHENJianfa, LIUYong. EFFECTIVENESS OF UC ULTRA-CONGRUENT ROTATING PLATFORM PROSTHESIS IN TREATMENT OF KNEE OSTEOARTHRITIS. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(11): 1342-1347. doi: 10.7507/1002-1892.20150290 Copy

1.	Cournapeau J, Klouche S, Bauer T, et al. Survival and functional results after a mean follow-up of 9 years with the Ceragyr^® highly congruent mobile-bearing TKA. Orthop Traumatol Surg Res, 2015, 101(4):455-460.
2.	Solarino G, Spinarelli A, Carrozzo M, et al. Long-term outcome of low contact stress total knee arthroplasty with different mobile bearing designs. Joints, 2014, 2(3):109-114.
3.	Feng B, Weng X, Lin J, et al. Long-term follow-up of cemented fixedbearing total knee arthroplasty in a Chinese population:a survival analysis of more than 10 years. J Arthroplasty, 2013, 28(10):1701-1706.
4.	Nguyen LC, Lehil MS, Bozic KJ. Trends in total knee arthroplasty implant utilization. J Arthroplasty, 2015, 30(5):739-742.
5.	Chavoix JB. Functionality and safety of an ultra-congruent rotating platform knee prosthesis at 5.6 years:more than 5-year follow-up of the e.motion^®UC-TKA. Open Orthop J, 2013, 7:152-157.
6.	Machhindra MV, Kang JY, Kang YG, et al. Functional outcomes of a new mobile-bearing ultra-congruent TKA system:comparison with the posterior stabilized system. J Arthroplasty, 2015.[Epub ahead of print].
7.	Hofmann AA, Tkach TK, Evanich CJ, et al. Posterior stabilization in total knee arthroplasty with use of an ultracongruent polyethylene insert. J Arthroplasty, 2000, 15(5):576-583.
8.	Kretzer JP, Jakubowitz E, Sonntag R, et al. Effect of joint laxity on polyethylene wear in total knee replacement. J Biomech, 2010, 43(6):1092-1096.
9.	Ko YB, Jang EC, Park SM, et al. No difference in clinical and radiologic outcomes after total knee arthroplasty with a new ultracongruent mobile bearing system and rotating platform mobile bearing systems after minimum 5-year follow-up. J Arthroplasty, 2015, 30(3):379-383.
10.	Bailey O, Ferguson K, Crawfurd E, et al. No clinical difference between fixed- and mobile-bearing cruciate-retaining total knee arthroplasty:a prospective randomized study. Knee Surg Sports Traumatol Arthrosc, 2015, 23(6):1653-1659.
11.	Poirier N, Graf P, Dubrana F, et al. Mobile-bearing versus fixedbearing total knee implants. Results of a series of 100 randomised cases after 9 years follow-up. Orthop Traumatol Surg Res, 2015, 101(4 Suppl):S187-S192.
12.	Ji HM, Ha YC, Baek JH, et al. Advantage of minimal anterior knee pain and long-term survivorship of cemented single radius posterior-stabilized total knee arthroplasty without patella resurfacing. Clin Orthop Surg, 2015, 7(1):54-61.
13.	Hack J, Mai S, Siebert W. 10-year follow-up of the NexGen CR total knee prosthesis. Z Orthop Unfall, 2015, 153(5):508-515.
14.	Carothers JT, Kim RH, Dennis DA, et al. Mobile-bearing total knee arthroplasty:a meta-analysis. J Arthroplasty, 2011, 26(4):537-542.
15.	Kim YH, Kim JS, Choe JW, et al. Long-term comparison of fixedbearing and mobile-bearing total knee replacements in patients younger than fifty-one years of age with osteoarthritis. J Bone Joint Surg (Am), 2012, 94(10):866-873.
16.	Lemaire RG. Mid-term results with a highly congruous mobilebearing knee prosthesis. Knee Surg Sports Traumatol Arthrosc, 2010, 18(2):170-180.
17.	Feng B, Weng X, Lin J, et al. Long term follow up of clinical outcome between patellar resurfacing and nonresurfacing in total knee arthroplasty:Chinese experience. Chin Med J (Engl), 2014, 127(22):3845-3851.
18.	Arirachakaran A, Sangkaew C, Kongtharvonskul J. Patellofemoral resurfacing and patellar denervation in primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2015, 23(6):1770-1781.

1. Cournapeau J, Klouche S, Bauer T, et al. Survival and functional results after a mean follow-up of 9 years with the Ceragyr^® highly congruent mobile-bearing TKA. Orthop Traumatol Surg Res, 2015, 101(4):455-460.
2. Solarino G, Spinarelli A, Carrozzo M, et al. Long-term outcome of low contact stress total knee arthroplasty with different mobile bearing designs. Joints, 2014, 2(3):109-114.
3. Feng B, Weng X, Lin J, et al. Long-term follow-up of cemented fixedbearing total knee arthroplasty in a Chinese population:a survival analysis of more than 10 years. J Arthroplasty, 2013, 28(10):1701-1706.
4. Nguyen LC, Lehil MS, Bozic KJ. Trends in total knee arthroplasty implant utilization. J Arthroplasty, 2015, 30(5):739-742.
5. Chavoix JB. Functionality and safety of an ultra-congruent rotating platform knee prosthesis at 5.6 years:more than 5-year follow-up of the e.motion^®UC-TKA. Open Orthop J, 2013, 7:152-157.
6. Machhindra MV, Kang JY, Kang YG, et al. Functional outcomes of a new mobile-bearing ultra-congruent TKA system:comparison with the posterior stabilized system. J Arthroplasty, 2015.[Epub ahead of print].
7. Hofmann AA, Tkach TK, Evanich CJ, et al. Posterior stabilization in total knee arthroplasty with use of an ultracongruent polyethylene insert. J Arthroplasty, 2000, 15(5):576-583.
8. Kretzer JP, Jakubowitz E, Sonntag R, et al. Effect of joint laxity on polyethylene wear in total knee replacement. J Biomech, 2010, 43(6):1092-1096.
9. Ko YB, Jang EC, Park SM, et al. No difference in clinical and radiologic outcomes after total knee arthroplasty with a new ultracongruent mobile bearing system and rotating platform mobile bearing systems after minimum 5-year follow-up. J Arthroplasty, 2015, 30(3):379-383.
10. Bailey O, Ferguson K, Crawfurd E, et al. No clinical difference between fixed- and mobile-bearing cruciate-retaining total knee arthroplasty:a prospective randomized study. Knee Surg Sports Traumatol Arthrosc, 2015, 23(6):1653-1659.
11. Poirier N, Graf P, Dubrana F, et al. Mobile-bearing versus fixedbearing total knee implants. Results of a series of 100 randomised cases after 9 years follow-up. Orthop Traumatol Surg Res, 2015, 101(4 Suppl):S187-S192.
12. Ji HM, Ha YC, Baek JH, et al. Advantage of minimal anterior knee pain and long-term survivorship of cemented single radius posterior-stabilized total knee arthroplasty without patella resurfacing. Clin Orthop Surg, 2015, 7(1):54-61.
13. Hack J, Mai S, Siebert W. 10-year follow-up of the NexGen CR total knee prosthesis. Z Orthop Unfall, 2015, 153(5):508-515.
14. Carothers JT, Kim RH, Dennis DA, et al. Mobile-bearing total knee arthroplasty:a meta-analysis. J Arthroplasty, 2011, 26(4):537-542.
15. Kim YH, Kim JS, Choe JW, et al. Long-term comparison of fixedbearing and mobile-bearing total knee replacements in patients younger than fifty-one years of age with osteoarthritis. J Bone Joint Surg (Am), 2012, 94(10):866-873.
16. Lemaire RG. Mid-term results with a highly congruous mobilebearing knee prosthesis. Knee Surg Sports Traumatol Arthrosc, 2010, 18(2):170-180.
17. Feng B, Weng X, Lin J, et al. Long term follow up of clinical outcome between patellar resurfacing and nonresurfacing in total knee arthroplasty:Chinese experience. Chin Med J (Engl), 2014, 127(22):3845-3851.
18. Arirachakaran A, Sangkaew C, Kongtharvonskul J. Patellofemoral resurfacing and patellar denervation in primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2015, 23(6):1770-1781.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF UC ULTRA-CONGRUENT ROTATING PLATFORM PROSTHESIS IN TREATMENT OF KNEE OSTEOARTHRITIS

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