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Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_II | Pages 249 - 249
1 May 2009
Davoudpour P Bourne R Ieda T Naudie D Rorabeck C
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The purpose of this study is to compare the long-term clinical results of two total knee replacement designs (the SAL-II mobile-bearing implant and the fixed-bearing Genesis I implant) to see if there are any advantages to the use of a mobile-bearing design in the long-term.

One hundred and ninety-two patients with an age range between twenty-five to ninety who were implanted with either an SAL-II (Group A) or GEN I (Group B) at London Health Sciences Center, University of Western Ontario, were included in the study. Patients with a diagnosis of inflammatory arthritis or with previous high tibial osteotomy were excluded from the study. Demographic data as well as functional outcome measures such as range of motion, knee alignment, specific measures of activities with daily tasks, and composite knee scores such as the Knee Society Clinical Score and Functional Score were collected from the patients’ medical charts and compared. Data was analyzed using SPSS V14.0 statistical software.

Group A included eighty-three mobile-bearing platform arthroplasties in seventy-seven patients. There were forty-one males and thirty-six females. The average age of the patients at the time of surgery was 67.7. Average follow up time was 10.56 years from the date of surgery. Eleven patients were excluded from the study, ten due to previous HTO surgery and one due to rheumatoid arthritis. At latest follow-up, ten patients required revision, and fifteen patients died. Group B included one hundred and thirty-one fixed-bearing knee arthroplasties in one hundred and fourteen patients. There were forty-one males and seventy-three females. The average age of the patients at the time of surgery was 65.8. Average follow up time was 9.58 years from the date of surgery. Twenty five patients were excluded from the study, twenty three patients due to previous HTO surgery and two patients due to rheumatoid arthritis. At latest follow-up, thirteen patients required revision, and twelve patients had died. Include Results and p-values at this stage. No statistically significant difference was found between the groups, either for the knee score (p=0.536), the function score (p=0.115), the range of movement (p=0.718) and number of revisions. Ten years survivorship for mobile bearing group was significantly lower than the fixed bearing group (p=0.005) although this equalised at fifteen years.

This study is the first long-term study that compares the results of the mobile-bearing and fixed bearing designs performed by the same surgeons in the same period of time. The results of this study show no difference in these two designs at a mean of ten years follow-up although fixed bearing design demonstrated better overall ten years survivorship. This difference can be related to the earlier mobile bearing revisions due to aseptic loosening and instability. Mobile bearing designs have yet to prove their theoretical advantage in clinical practice.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 373 - 373
1 Mar 2004
Hiraishi E Ogawa S Sakihara H Honma T Yasui S Ieda T
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Aims: To clarify correlation between magnetic resonance imaging (MRI) and pathology of pain in posterior aspect of the ankle in ballet dancers. Methods: Twenty feet of þfteen patients, who underwent surgery with the average age of 19.2 years, were retrospectively analyzed. They were diagnosed as ßexor hallucis longus (FHL) tendon injury or posterior ankle impingement (PAI) syndrome mainly based on physical signs. MRI þndings of FHL tendon were classiþed with the classiþcation of posterior tibial tendon dysfunction presented by Conti et al., and were compared with macroscopic changes of the tendon. FHL injuries were classiþed as follows; paratendinitis as grade-1, superþcial injury (< 1/2 thickness) as grade-2, and deep injury as grade-3. MRI þndings of PAI syndrome were also compared to surgical and histological þndings. Results: Correlation of FHL tendon injury with MRI þndings was presented on the table. There was a case with a ganglion cyst of FHL tendon presented on MRI. There were, however, two cases with ganglions on þbro-osseous tunnel MRI could not reveal. In four feet of three patients, bone marrow edema in os trigonum or posterior part of the talus was observed. Conclusion: MRI was useful to investigate the pathology of pain in posterior aspect of the ankle.