Midterm results of modular hinge total knee arthroplasty using cementless osseointegrating stems: low fixation associated complications and good functional outcome in primary and revision knee arthroplasty
Purpose This study aimed to investigate functional outcome and complications after primary and revision modular H-TKA using hybrid fixation with cementless stems. Methods Between 2015 and 2018, 48 patients with 50 implants were included after hybrid implantation of a single design H-TKA system using...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2024-02, Vol.144 (2), p.831-845 |
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| creator | Schnetz, M. Hofmann, L. Ewald, L. Klug, A. Hoffmann, R. Gramlich, Y. |
| description | Purpose
This study aimed to investigate functional outcome and complications after primary and revision modular H-TKA using hybrid fixation with cementless stems.
Methods
Between 2015 and 2018, 48 patients with 50 implants were included after hybrid implantation of a single design H-TKA system using cementless osseointegrating stems and modular components. Complications and clinical outcome were analysed using Knee Society Score (KSS), the Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) and the Short-Form Health Survey 12 (SF-12) score.
Results
Indications for implantation were aseptic revision (
n
= 29, 58%), primary TKA (
n
= 19, 38%) and two-stage septic revisions (
n
= 2, 4%). Complications were reported in 26% (
n
= 12), whereas complications associated with hybrid fixation occurred in 5 (10%) cases, with 2 (4%) requiring revision surgery for aseptic loosening and 3 (6%) treated with an adapted postoperative protocol for perioperative fractures. Implant survivorship was 84% after a mean follow-up of 54 months. Postoperative KSS significantly improved from 51.50 (12–100) to 78.36 (41–99;
p
|
| doi_str_mv | 10.1007/s00402-023-05148-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2902963509</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2902963509</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-676144de16d6aaed202a4ef938cc758f56df68c55a29ebe048053011c59f3c673</originalsourceid><addsrcrecordid>eNp9kctu1TAQhiNERUvhBVggS2zYhI7txHHYoYqb1IoNrCPXnpy6OPHB4wB9SN4J55wDVCCxsjXzzT-Xv6qecHjBAbozAmhA1CBkDS1vdN3dq054I5ta9lzdv_M_rh4S3QBwoXt4UB1LDUpqLU6qH5feZUwTS0hLyMTiyKbolmASu_bzBlmO2QT2eUZkJuXrFLfBUL5lC5U0szjhnANSqSTC6OeMm2TymqOME71kIX5jo_9eYnFmhihabzI6ZuO0Dd7u4sTM7NgmRsfGZbZrqDSNSy4QMj-zbfKTSbc7LOFXT6vYP0M9qo5GEwgfH97T6tOb1x_P39UXH96-P391UVspVK5Vp3jTOOTKKWPQCRCmwbGX2tqu1WOr3Ki0bVsjerxCaDS0Eji3bT9Kqzp5Wj3f625T_LIg5WHyZDEEM2NcaBA9iF7JFvqCPvsLvYlLKtutFO8FaNXoQok9ZVM5Y8JxOCw8cBhWs4e92UMxe9iZPaxTPD1IL1cTut8lv9wtgNwDVFLFy_Sn939kfwLJ0Ltv</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2919208648</pqid></control><display><type>article</type><title>Midterm results of modular hinge total knee arthroplasty using cementless osseointegrating stems: low fixation associated complications and good functional outcome in primary and revision knee arthroplasty</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Schnetz, M. ; Hofmann, L. ; Ewald, L. ; Klug, A. ; Hoffmann, R. ; Gramlich, Y.</creator><creatorcontrib>Schnetz, M. ; Hofmann, L. ; Ewald, L. ; Klug, A. ; Hoffmann, R. ; Gramlich, Y.</creatorcontrib><description>Purpose
This study aimed to investigate functional outcome and complications after primary and revision modular H-TKA using hybrid fixation with cementless stems.
Methods
Between 2015 and 2018, 48 patients with 50 implants were included after hybrid implantation of a single design H-TKA system using cementless osseointegrating stems and modular components. Complications and clinical outcome were analysed using Knee Society Score (KSS), the Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) and the Short-Form Health Survey 12 (SF-12) score.
Results
Indications for implantation were aseptic revision (
n
= 29, 58%), primary TKA (
n
= 19, 38%) and two-stage septic revisions (
n
= 2, 4%). Complications were reported in 26% (
n
= 12), whereas complications associated with hybrid fixation occurred in 5 (10%) cases, with 2 (4%) requiring revision surgery for aseptic loosening and 3 (6%) treated with an adapted postoperative protocol for perioperative fractures. Implant survivorship was 84% after a mean follow-up of 54 months. Postoperative KSS significantly improved from 51.50 (12–100) to 78.36 (41–99;
p
< 0.001). The mean WOMAC score was 19.26 (0–55), SF-12 PCS was 41.56 points (22.67–57.66) and SF-12 MCS was 49.21 points (23.87–63.21).
Conclusion
Hybrid modular implantation in H-TKA provides satisfactory clinical and functional results in primary and revision TKA. Clinical outcomes significantly improve with reduced pain, increased mobility, and good-to-excellent functional scores after implantation. Whilst implant survival is comparable to previous studies and complications associated with hybrid fixation are low, general complication rates are comparably high.</description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-023-05148-7</identifier><identifier>PMID: 38063882</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Arthroplasty, Replacement, Knee - adverse effects ; Arthroplasty, Replacement, Knee - methods ; Humans ; Joint replacement surgery ; Knee Joint - surgery ; Knee Prosthesis - adverse effects ; Knee Revision Surgery ; Medicine ; Medicine & Public Health ; Orthopedics ; Pain - surgery ; Prosthesis Design ; Reoperation ; Transplants & implants ; Treatment Outcome</subject><ispartof>Archives of orthopaedic and trauma surgery, 2024-02, Vol.144 (2), p.831-845</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-676144de16d6aaed202a4ef938cc758f56df68c55a29ebe048053011c59f3c673</cites><orcidid>0000-0003-0901-2801</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-023-05148-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-023-05148-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38063882$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schnetz, M.</creatorcontrib><creatorcontrib>Hofmann, L.</creatorcontrib><creatorcontrib>Ewald, L.</creatorcontrib><creatorcontrib>Klug, A.</creatorcontrib><creatorcontrib>Hoffmann, R.</creatorcontrib><creatorcontrib>Gramlich, Y.</creatorcontrib><title>Midterm results of modular hinge total knee arthroplasty using cementless osseointegrating stems: low fixation associated complications and good functional outcome in primary and revision knee arthroplasty</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Purpose
This study aimed to investigate functional outcome and complications after primary and revision modular H-TKA using hybrid fixation with cementless stems.
Methods
Between 2015 and 2018, 48 patients with 50 implants were included after hybrid implantation of a single design H-TKA system using cementless osseointegrating stems and modular components. Complications and clinical outcome were analysed using Knee Society Score (KSS), the Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) and the Short-Form Health Survey 12 (SF-12) score.
Results
Indications for implantation were aseptic revision (
n
= 29, 58%), primary TKA (
n
= 19, 38%) and two-stage septic revisions (
n
= 2, 4%). Complications were reported in 26% (
n
= 12), whereas complications associated with hybrid fixation occurred in 5 (10%) cases, with 2 (4%) requiring revision surgery for aseptic loosening and 3 (6%) treated with an adapted postoperative protocol for perioperative fractures. Implant survivorship was 84% after a mean follow-up of 54 months. Postoperative KSS significantly improved from 51.50 (12–100) to 78.36 (41–99;
p
< 0.001). The mean WOMAC score was 19.26 (0–55), SF-12 PCS was 41.56 points (22.67–57.66) and SF-12 MCS was 49.21 points (23.87–63.21).
Conclusion
Hybrid modular implantation in H-TKA provides satisfactory clinical and functional results in primary and revision TKA. Clinical outcomes significantly improve with reduced pain, increased mobility, and good-to-excellent functional scores after implantation. Whilst implant survival is comparable to previous studies and complications associated with hybrid fixation are low, general complication rates are comparably high.</description><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Humans</subject><subject>Joint replacement surgery</subject><subject>Knee Joint - surgery</subject><subject>Knee Prosthesis - adverse effects</subject><subject>Knee Revision Surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Pain - surgery</subject><subject>Prosthesis Design</subject><subject>Reoperation</subject><subject>Transplants & implants</subject><subject>Treatment Outcome</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1TAQhiNERUvhBVggS2zYhI7txHHYoYqb1IoNrCPXnpy6OPHB4wB9SN4J55wDVCCxsjXzzT-Xv6qecHjBAbozAmhA1CBkDS1vdN3dq054I5ta9lzdv_M_rh4S3QBwoXt4UB1LDUpqLU6qH5feZUwTS0hLyMTiyKbolmASu_bzBlmO2QT2eUZkJuXrFLfBUL5lC5U0szjhnANSqSTC6OeMm2TymqOME71kIX5jo_9eYnFmhihabzI6ZuO0Dd7u4sTM7NgmRsfGZbZrqDSNSy4QMj-zbfKTSbc7LOFXT6vYP0M9qo5GEwgfH97T6tOb1x_P39UXH96-P391UVspVK5Vp3jTOOTKKWPQCRCmwbGX2tqu1WOr3Ki0bVsjerxCaDS0Eji3bT9Kqzp5Wj3f625T_LIg5WHyZDEEM2NcaBA9iF7JFvqCPvsLvYlLKtutFO8FaNXoQok9ZVM5Y8JxOCw8cBhWs4e92UMxe9iZPaxTPD1IL1cTut8lv9wtgNwDVFLFy_Sn939kfwLJ0Ltv</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Schnetz, M.</creator><creator>Hofmann, L.</creator><creator>Ewald, L.</creator><creator>Klug, A.</creator><creator>Hoffmann, R.</creator><creator>Gramlich, Y.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0901-2801</orcidid></search><sort><creationdate>20240201</creationdate><title>Midterm results of modular hinge total knee arthroplasty using cementless osseointegrating stems: low fixation associated complications and good functional outcome in primary and revision knee arthroplasty</title><author>Schnetz, M. ; Hofmann, L. ; Ewald, L. ; Klug, A. ; Hoffmann, R. ; Gramlich, Y.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-676144de16d6aaed202a4ef938cc758f56df68c55a29ebe048053011c59f3c673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Arthroplasty, Replacement, Knee - methods</topic><topic>Humans</topic><topic>Joint replacement surgery</topic><topic>Knee Joint - surgery</topic><topic>Knee Prosthesis - adverse effects</topic><topic>Knee Revision Surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Pain - surgery</topic><topic>Prosthesis Design</topic><topic>Reoperation</topic><topic>Transplants & implants</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schnetz, M.</creatorcontrib><creatorcontrib>Hofmann, L.</creatorcontrib><creatorcontrib>Ewald, L.</creatorcontrib><creatorcontrib>Klug, A.</creatorcontrib><creatorcontrib>Hoffmann, R.</creatorcontrib><creatorcontrib>Gramlich, Y.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schnetz, M.</au><au>Hofmann, L.</au><au>Ewald, L.</au><au>Klug, A.</au><au>Hoffmann, R.</au><au>Gramlich, Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Midterm results of modular hinge total knee arthroplasty using cementless osseointegrating stems: low fixation associated complications and good functional outcome in primary and revision knee arthroplasty</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>144</volume><issue>2</issue><spage>831</spage><epage>845</epage><pages>831-845</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Purpose
This study aimed to investigate functional outcome and complications after primary and revision modular H-TKA using hybrid fixation with cementless stems.
Methods
Between 2015 and 2018, 48 patients with 50 implants were included after hybrid implantation of a single design H-TKA system using cementless osseointegrating stems and modular components. Complications and clinical outcome were analysed using Knee Society Score (KSS), the Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) and the Short-Form Health Survey 12 (SF-12) score.
Results
Indications for implantation were aseptic revision (
n
= 29, 58%), primary TKA (
n
= 19, 38%) and two-stage septic revisions (
n
= 2, 4%). Complications were reported in 26% (
n
= 12), whereas complications associated with hybrid fixation occurred in 5 (10%) cases, with 2 (4%) requiring revision surgery for aseptic loosening and 3 (6%) treated with an adapted postoperative protocol for perioperative fractures. Implant survivorship was 84% after a mean follow-up of 54 months. Postoperative KSS significantly improved from 51.50 (12–100) to 78.36 (41–99;
p
< 0.001). The mean WOMAC score was 19.26 (0–55), SF-12 PCS was 41.56 points (22.67–57.66) and SF-12 MCS was 49.21 points (23.87–63.21).
Conclusion
Hybrid modular implantation in H-TKA provides satisfactory clinical and functional results in primary and revision TKA. Clinical outcomes significantly improve with reduced pain, increased mobility, and good-to-excellent functional scores after implantation. Whilst implant survival is comparable to previous studies and complications associated with hybrid fixation are low, general complication rates are comparably high.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38063882</pmid><doi>10.1007/s00402-023-05148-7</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0003-0901-2801</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1434-3916 |
| ispartof | Archives of orthopaedic and trauma surgery, 2024-02, Vol.144 (2), p.831-845 |
| issn | 1434-3916 0936-8051 1434-3916 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Arthroplasty, Replacement, Knee - adverse effects Arthroplasty, Replacement, Knee - methods Humans Joint replacement surgery Knee Joint - surgery Knee Prosthesis - adverse effects Knee Revision Surgery Medicine Medicine & Public Health Orthopedics Pain - surgery Prosthesis Design Reoperation Transplants & implants Treatment Outcome |
| title | Midterm results of modular hinge total knee arthroplasty using cementless osseointegrating stems: low fixation associated complications and good functional outcome in primary and revision knee arthroplasty |
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