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J Knee Surg 2012; 25(03): 249-254
DOI: 10.1055/s-0031-1299660
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Functional Outcomes Used to Compare Single Radius and Multiradius of Curvature Designs in Total Knee Arthroplasty

Laurence E. Cook
1   School of Medicine, Case Western Reserve University, Cleveland, Ohio
,
Alison K. Klika
2   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
,
Caleb R. Szubski
2   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
,
James Rosneck
2   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
,
Robert Molloy
2   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
,
Wael K. Barsoum
2   Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
› Author Affiliations
Further Information

Publication History

27 April 2011

05 October 2011

Publication Date:
03 May 2012 (online)

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Abstract

A recent development to better recreate joint kinematics has been a change from a multiradius (MR) design to a single radius (SR) design. We analyzed 559 primary total knee arthroplasty (TKA) procedures which used either a SR (n = 426 Triathlon®; Stryker Orthopaedics, Mahwah, NJ) or MR of curvature knee system (n = 133 Duracon®; Stryker Orthopaedics, Mahwah, NJ) (79.3% follow-up; 705 total TKA procedures identified). Patients were administered a modification of the Knee Society score (KSS) (3.9 years average follow-up). The SR design showed improvements over the MR design in pain (p = 0.021), stability (p = 0.002), flexion (p = 0.006), ability to completely straighten the knee (p = 0.025), stair climbing (p = 0.0001), walking (p = 0.0001), use of assistive devices (p = 0.0005), postoperative knee score (p = 0.0005), and postoperative function (p < 0.0001). Analysis of the change in KSS knee (p = 0.002) and function scores (p = 0.002) from preoperative visit to postoperative follow-up favored the SR design as well. These data support the use of SR implants and provide evidence of improved outcomes in terms of function, stability, and pain.

Keywords

total knee arthroplasty - single radius - multiradius - implant design - function
 

  • References

  • 1 Fries JF. Aging, natural death, and the compression of morbidity. N Engl J Med 1980; 303 (3) 130-135
    CrossrefPubMedSearch in Google Scholar
  • 2 Hollister AM, Jatana S, Singh AK, Sullivan WW, Lupichuk AG. The axes of rotation of the knee. Clin Orthop Relat Res 1993; (290) 259-268
    PubMedSearch in Google Scholar
  • 3 Wang H, Simpson KJ, Ferrara MS, Chamnongkich S, Kinsey T, Mahoney OM. Biomechanical differences exhibited during sit-to-stand between total knee arthroplasty designs of varying radii. J Arthroplasty 2006; 21 (8) 1193-1199
    CrossrefPubMedSearch in Google Scholar
  • 4 Churchill DL, Incavo SJ, Johnson CC, Beynnon BD. The transepicondylar axis approximates the optimal flexion axis of the knee. Clin Orthop Relat Res 1998; (356) 111-118
    PubMedSearch in Google Scholar
  • 5 Mahoney OM, McClung CD, dela Rosa MA, Schmalzried TP. The effect of total knee arthroplasty design on extensor mechanism function. J Arthroplasty 2002; 17 (4) 416-421
    CrossrefPubMedSearch in Google Scholar
  • 6 D’Lima DD, Poole C, Chadha H, Hermida JC, Mahar A, Colwell Jr CW. Quadriceps moment arm and quadriceps forces after total knee arthroplasty. Clin Orthop Relat Res 2001; (392) 213-220
    PubMedSearch in Google Scholar
  • 7 Browne C, Hermida JC, Bergula A, Colwell Jr CW, D’Lima DD. Patellofemoral forces after total knee arthroplasty: effect of extensor moment arm. Knee 2005; 12 (2) 81-88
    CrossrefPubMedSearch in Google Scholar
  • 8 Gómez-Barrena E, Fernandez-García C, Fernandez-Bravo A, Cutillas-Ruiz R, Bermejo-Fernandez G. Functional performance with a single-radius femoral design total knee arthroplasty. Clin Orthop Relat Res 2010; 468 (5) 1214-1220
    CrossrefPubMedSearch in Google Scholar
  • 9 Hall J, Copp SN, Adelson WS, D’Lima DD, Colwell Jr CW. Extensor mechanism function in single-radius vs multiradius femoral components for total knee arthroplasty. J Arthroplasty 2008; 23 (2) 216-219
    CrossrefPubMedSearch in Google Scholar
  • 10 Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 1989; (248) 13-14
    PubMedSearch in Google Scholar
  • 11 Worland RL, Johnson GV, Alemparte J, Jessup DE, Keenan J, Norambuena N. Ten to fourteen year survival and functional analysis of the AGC total knee replacement system. Knee 2002; 9 (2) 133-137
    CrossrefPubMedSearch in Google Scholar
  • 12 Harwin SF, Greene KA, Hitt K. Triathlon total knee arthroplasty: 4-year outcomes with a high-performance implant. J Knee Surg 2008; 21 (4) 320-326
    Thieme ConnectPubMedSearch in Google Scholar
  • 13 Wang H, Simpson KJ, Chamnongkich S, Kinsey T, Mahoney OM. A biomechanical comparison between the single-axis and multi-axis total knee arthroplasty systems for the stand-to-sit movement. Clin Biomech (Bristol, Avon) 2005; 20 (4) 428-433
    CrossrefPubMedSearch in Google Scholar
  • 14 Harwin SF, Kester M. Single radius total knee arthroplasty: PCL sacrifice without substitution yields excellent outcomes minimum 8-year follow-up. Surg Technol Int 2010; 19: 191-198
    PubMedSearch in Google Scholar
  • 15 Heiberg KE, Bruun-Olsen V, Mengshoel AM. Pain and recovery of physical functioning nine months after total knee arthroplasty. J Rehabil Med 2010; 42 (7) 614-619
    CrossrefPubMedSearch in Google Scholar
  • 16 Brander VA, Malhotra S, Jet J, Heinemann AW, Stulberg SD. Outcome of hip and knee arthroplasty in persons aged 80 years and older. Clin Orthop Relat Res 1997; (345) 67-78
    PubMedSearch in Google Scholar
  • 17 Zicat B, Rorabeck CH, Bourne RB, Devane PA, Nott L. Total knee arthroplasty in the octogenarian. J Arthroplasty 1993; 8 (4) 395-400
    CrossrefPubMedSearch in Google Scholar
  • 18 Birdsall PD, Hayes JH, Cleary R, Pinder IM, Moran CG, Sher JL. Health outcome after total knee replacement in the very elderly. J Bone Joint Surg Br 1999; 81 (4) 660-662
    CrossrefPubMedSearch in Google Scholar
  • 19 Jones CA, Voaklander DC, Johnston DW, Suarez-Almazor ME. The effect of age on pain, function, and quality of life after total hip and knee arthroplasty. Arch Intern Med 2001; 161 (3) 454-460
    CrossrefPubMedSearch in Google Scholar
  • 20 Sastre S, Sanchez MD, Lozano L, Orient F, Fontg F, Nuñez M. Total knee arthroplasty: better short-term results after subvastus approach: a randomized, controlled study. Knee Surg Sports Traumatol Arthrosc 2009; 17 (10) 1184-1188
    CrossrefPubMedSearch in Google Scholar
  • 21 Weinhardt C, Barisic M, Bergmann EG, Heller KD. Early results of subvastus versus medial parapatellar approach in primary total knee arthroplasty. Arch Orthop Trauma Surg 2004; 124 (6) 401-403
    PubMedSearch in Google Scholar