Non-hinged constrained condylar components (CCK) may be used for primary TKA in presence of severe deformity, fixed contractures and ligamentous laxity. Several authors have recommended use of stem extensions to accompany CCK type of components. However, use of stem extensions in primary TKA, not only invades the medullary canal, but may also be associated with increased surgical time, implant cost, and thigh or leg pain. The purpose of this study was to assess the short-term outcomes of primary CCK knees without stem extensions and to compare this to a control group of standard posterior stabilized (PS) knees, otherwise using the same implant design. We retrospectively reviewed the clinical and radiographic data on 503 consecutive TKA's performed by 2 arthroplasty surgeons at the same institution between 2008–2010. Surgical technique, implant type, bone-cement and cementation technique was similar. The only difference between groups was the use of CCK polyethylene insert in one group and a PS insert in the other. Knee society scores (KSS) were used to determine pain, function and ROM. Radiographic evaluation was done using the knee society's criteria to determine implant fixation. Failure was defined as revision for any reason. Statistical analyses were performed using SPSS software.Introduction:
Materials and Methods:
Dual mobility components in total hip arthroplasty have been successfully in use in Europe for greater than 25 years. However, these implants have only recently obtained FDA approval and acceptance among North American arthroplasty surgeons. Both decreased dislocation rate and decreased wear rates have been proposed benefits of dual mobility components. These components have been used for primary total hip arthroplasty in patients at high risk for dislocation, total hip arthroplasty in the setting of femoral neck fracture, revision for hip instability, and revision for large metal-on-metal (MoM) hip articulation. The literature for the North American experience is lacking. We report indications, short term outcomes, and complications of a series of subjects who received dual mobility outcomes at one institution.Background:
Purpose:
Revision surgery for failed metal-on-metal (MOM) total hip arthroplasty (THA) or hip resurfacing (HR) has been a challenge. Previous studies have reported high failure and complication rates, including dislocation, infection, aseptic loosening and lower patient satisfaction. Options for revision depend on the integrity and stability of the femoral and acetabular components. When both components fail, full revision is required; however, when the acetabular component remains well fixed and oriented, only the isolated femoral component revision can be performed. Dual mobility components can be utilized to match the size to the inner diameter of the metal cup. With the dual mobility implant, the morbidity and complications associated with cup revision are avoided while maintaining a natural femoral head size and potentially increasing range of motion and stability postoperatively compared to standard THA. The aim of this study was to evaluate short- to mid-term results of revision THA after failed metal-on-metal THA or HR using the dual mobility device.Background
Purpose
