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Posteriorly stabilised (Insall-Burstein) total condylar knee arthroplasty

A follow-up study of 157 knees

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Summary

We reviewed 157 knees in 118 patients who underwent posteriorly stabilised (Insall-Burstein) knee replacement arthroplasty. Their mean age at operation was 69 years (range 47 to 85 years) and the average follow-up was 3.5 years (range 2 to 7 years). The “BASK” knee function assessment chart was utilised to evaluate the functional and clinical results. One hundred and thirty-five knees (86%) had excellent or good results, 16 knees (10%) had fair results and six (4%) had poor results. The mean postoperative BASK score was 79 points and the average postoperative knee flexion was 95° (range 65° to 130°). Two patients had a superficial infection, one deep sepsis requiring revision arthroplasty and two mechanical loosening. Patellar impingement symptoms were present in 8% of the knees, although they were troublesome in less than half. Varus alignment of the knee and a varus tilt of the tibial component of more than 2° correlated with the incidence of radiolucent lines around the tibial prosthesis. 90% of the patients were pleased or satisfied with the functional result. The total condylar knee is a safe, reliable and versatile prosthesis.

Résumé

Nous avons revu 157 genoux chez 118 malades ayant bénéficié d'une arthroplastie par prothèse semi-contrainte (Insall-Burstein). L'âge moyen lors de l'opération était de 69 ans (de 47 à 85) et le recul moyen était de 3 ans et demi (de 2 à 7). Pour évaluer les résultats fonctionnels et cliniques, nous avons eu recours à l'échelle de cotation fonctionnelle «BASK». Le résultat était excellent ou bon dans 135 genoux (86%), moyen dans 16 (10%) et mauvais dans 6 (4%). La cotation post-opératoire «BASK» était en moyenne de 79 points et la flexion post-opératoire moyenne de 95° (de 65° à 130°). Deux opérés avaient présenté une infection superficielle, un seul un sepsis profond ayant nécessité une reprise de l'arthroplastie et deux un descellement mécanique. Des signes d'hyperpression rotulienne pouvaient être notés dans 8% des genoux mais ils n'avaient de traduction clinique que dans moins de la moitié des cas. L'existence d'un liseré autour de la pièce tibiale êtait correlée avec une désaxation du genou en varus ou avec un positionnement en varus du composant tibial supérieur à 2°. La prothèse total-condylar est donc sûre, efficace et susceptible de s'adapter aux diverses éventualités.

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Patel, D.V., Aichroth, P.M. & Wand, J.S. Posteriorly stabilised (Insall-Burstein) total condylar knee arthroplasty. International Orthopaedics 15, 211–218 (1991). https://doi.org/10.1007/BF00192297

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Keywords

  • Tibial Component
  • Nous Avons
  • Radiolucent Line
  • Varus Alignment
  • Replacement Arthroplasty