Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2012 Feb;47(1):35-40. Korean.
    Published online Feb 29, 2012.
    https://doi.org/10.4055/jkoa.2012.47.1.35
    Copyright © 2012 by The Korean Orthopaedic Association
    Original Article

    Early Aseptic Loosening after Total Knee Replacement Using Legacy Posterior Stabilized-Flex Prosthesis

    Young-Joon Choi, M.D., Jeong-Ho Kang, M.D., Ki-Won Lee, M.D., Youn-Suk Joo, M.D., Jun-Seok Park, M.D. and Han-Ho Choo, M.D.
      • Department of Orthopaedic Surgery, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea.
    • Correspondence to: Jeong-Ho Kang, M.D. Department of Orthopaedic Surgery, Gangneung Asan Hospital, 415, Bangdong-ri, Sacheon-myeon, Gangneung 210-711, Korea. TEL: +82-33-610-3243, FAX: +82-33-641-8050, Email: theknee@naver.com
    Received May 31, 2011; Revised August 18, 2011; Accepted August 25, 2011.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Purpose

    We analyzed the patterns and causative factors of early aseptic loosening after total knee arthroplasty (TKR) using a legacy posterior stabilized (LPS)-flex prosthesis.

    Materials and Methods

    We examined 483 cases that occurred in 311 patients who underwent TKR using LPS-flex by single surgeon between August 2001 and March 2007 and who were followed-up for at least 2 years. The loosened group included 25 cases that exhibited early aseptic loosening on radiograph, the remaining 458 cases were regarded as the control group, and analysis was performed.

    Results

    The mean loosening period was 34.7 months and femoral component loosening alone was found in 22 cases (88%). There were no statistically significant differences in age, body mass index, or pre-operative range of motion between the 2 groups, but varus deformity was more severe in the loosened group (mean 8.92°) than in the control group (mean 5.21°) (p=0.003). Protrusion of the femoral component proximally over posterior condyle of the distal femur were more prominent in the loosened group (mean 20.3%) than in the control group (mean 13.4%) (p=0.001).

    Conclusion

    Early loosening after TKR using LPS-flex prosthesis developed mostly in the femoral component. Choosing a proper size for the femoral component and cutting level for the distal femur should be considered.

    Keywords
    femoral prosthesis; loosening; arthroplasty replacement total

    Figures

    Figure 1
    We measured the extent of protruded femoral component by the proportion of uncovered surface (A) to total length of posterior condyle of femoral component (B).

    Figure 2
    A 65-year-old female patient (A-D) had lateral radiographs taken at 13, 60, 77, and 84 months respectively, showing progressive loosening at anterior flange and posterior condyle with proximal migration of femoral component. (E) There was a scanty cement mantle on backside of the femoral component.

    Tables

    Table 1
    Patient Demographic and Radiographic Data

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    MeSH Terms
    Arthroplasty
    Arthroplasty, Replacement, Knee
    Body Mass Index
    Congenital Abnormalities
    Femur
    Humans
    Knee
    Prostheses and Implants
    Range of Motion, Articular
    Metrics
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