Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2017

01-06-2017 | Knee

Total and intercondylar notch bone resection in posterior stabilized knee arthroplasty: analysis of five manufacturer designs

Authors: Murat Bozkurt, Mesut Tahta, Safa Gursoy, Mustafa Akkaya

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2017

Login to get access

Abstract

Purpose

The study aimed to volumetrically measure and compare the bone amount removed through the intercondylar femoral notch and the total bone amount removed through five different brands of implant design in order to provide orthopaedic surgeons with opinions in respect of implant selection.

Methods

Ten implants from five different total knee arthroplasty implant manufacturers, namely Nex-Gen Legacy, Genesis 2 PS, Vanguard, Sigma PS and Scorpio NRG PS, were applied to a total of 50 sawbone models. Equal or the closest sizes of each brand on the anteroposterior plane were selected, and cuts were made following the standard technique. The removed bone pieces were measured in terms of volume and length in three planes, and were statistically analysed.

Results

The comparison made by excluding femoral notch cuts did not produce any statistically significant difference between the amounts of bone removed. The following data were volumetrically obtained from the intercondylar femoral notch cut: Vanguard (3.6 ± 0.4 cm3), Nex-Gen (3.7 ± 0.5 cm3), Sigma (5.7 ± 0.4 cm3), Genesis 2 (6.3 ± 0.3 cm3) and Scorpio NRG (6.7 ± 0.7 cm3). There was no statistical difference between Genesis 2 and Scorpio NRG (n.s.), or between Nex-Gen and Vanguard (n.s.). The smallest volumetric value measured in the removed intercondylar femoral notch cut was obtained using Vanguard.

Conclusion

There are significant differences between implant designs in terms of preserving bone stock, and a large proportion of the difference arises from the intercondylar femoral notch cut.
Literature
1.
go back to reference Abdel MP, Morrey ME, Jensen MR, Morrey BF (2011) Increased longterm survival of posterior cruciate-retaining versus posterior cruciate-stabilizing total knee replacements. J Bone Joint Surg Am 22:2072–2078CrossRef Abdel MP, Morrey ME, Jensen MR, Morrey BF (2011) Increased longterm survival of posterior cruciate-retaining versus posterior cruciate-stabilizing total knee replacements. J Bone Joint Surg Am 22:2072–2078CrossRef
2.
go back to reference Ding M, Odgaard A, Hvid I (1999) Accuracy of cancellous bone volume fraction measured by micro-CT scanning. J Biomech 32:323–326CrossRefPubMed Ding M, Odgaard A, Hvid I (1999) Accuracy of cancellous bone volume fraction measured by micro-CT scanning. J Biomech 32:323–326CrossRefPubMed
3.
go back to reference Haas SB, Nelson CL, Laskin RS (2000) Posterior stabilized knee arthroplasty: an assessment of bone resection. Knee 7:25–29CrossRef Haas SB, Nelson CL, Laskin RS (2000) Posterior stabilized knee arthroplasty: an assessment of bone resection. Knee 7:25–29CrossRef
4.
go back to reference Hernigou P, Mathieu G, Filippini P, Demoura A (2006) Intra and postoperative fractures of the femur in total knee arthroplasty: risk factors in 32 cases. Rev Chir Orthop Reparatrice Appar Mot 92:140–147CrossRefPubMed Hernigou P, Mathieu G, Filippini P, Demoura A (2006) Intra and postoperative fractures of the femur in total knee arthroplasty: risk factors in 32 cases. Rev Chir Orthop Reparatrice Appar Mot 92:140–147CrossRefPubMed
5.
go back to reference Huten D (2013) Femorotibial bone loss during revision total knee arthroplasty. Orthop Traumatol Surg Res 99:22–33CrossRef Huten D (2013) Femorotibial bone loss during revision total knee arthroplasty. Orthop Traumatol Surg Res 99:22–33CrossRef
6.
go back to reference Indelli PF, Marcucci M, Graceffa A, Charlton S, Latella L (2014) Primary posterior stabilized total knee arthroplasty: analysis of different instrumentation. J Orthop Surg Res 9:54CrossRefPubMedPubMedCentral Indelli PF, Marcucci M, Graceffa A, Charlton S, Latella L (2014) Primary posterior stabilized total knee arthroplasty: analysis of different instrumentation. J Orthop Surg Res 9:54CrossRefPubMedPubMedCentral
7.
go back to reference Kurtz S, Mowat F, Ong K, Chan N, Lau E, Halpern M (2005) Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am 7:1487–1497 Kurtz S, Mowat F, Ong K, Chan N, Lau E, Halpern M (2005) Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am 7:1487–1497
8.
go back to reference Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 4:780–785 Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 4:780–785
9.
go back to reference Lee SM, Seong SC, Lee S, Choi WC, Lee MC (2012) Outcomes of the different types of total knee arthroplasty with the identical femoral geometry. Knee Surg Relat Res 24:214–220CrossRefPubMedPubMedCentral Lee SM, Seong SC, Lee S, Choi WC, Lee MC (2012) Outcomes of the different types of total knee arthroplasty with the identical femoral geometry. Knee Surg Relat Res 24:214–220CrossRefPubMedPubMedCentral
10.
go back to reference Lombardi AV, Mallory TH, Waterman RA, Eberle RW (1995) Intercondylar distal femoral fracture: an unreported complication of posterior-stabilized total knee arthroplasty. J Arthroplasty 5:643–650CrossRef Lombardi AV, Mallory TH, Waterman RA, Eberle RW (1995) Intercondylar distal femoral fracture: an unreported complication of posterior-stabilized total knee arthroplasty. J Arthroplasty 5:643–650CrossRef
11.
go back to reference Mihalko WM, Boyle J, Clark LD, Krackow KA (2005) The variability of intramedullary alignment of the femoral component during total knee arthroplasty. J Arthroplasty 20:25–28CrossRefPubMed Mihalko WM, Boyle J, Clark LD, Krackow KA (2005) The variability of intramedullary alignment of the femoral component during total knee arthroplasty. J Arthroplasty 20:25–28CrossRefPubMed
12.
go back to reference Nikolopoulos DD, Polyzois IG, Magnissalis EA, Bernard PF, Michos IV (2012) Fracture at the stem-condylar junction of a modular femoral prosthesis in a varus-valgus constrained total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 20:1071–1074CrossRefPubMed Nikolopoulos DD, Polyzois IG, Magnissalis EA, Bernard PF, Michos IV (2012) Fracture at the stem-condylar junction of a modular femoral prosthesis in a varus-valgus constrained total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 20:1071–1074CrossRefPubMed
13.
go back to reference Novotny J, Gonzalez MH, Amirouche FM, Li YC (2001) Geometric analysis of potential error in using femoral intramedullary guides in total kneearthroplasty. J Arthroplasty 16:641–647CrossRefPubMed Novotny J, Gonzalez MH, Amirouche FM, Li YC (2001) Geometric analysis of potential error in using femoral intramedullary guides in total kneearthroplasty. J Arthroplasty 16:641–647CrossRefPubMed
14.
go back to reference Pietsch M, Hofmann S (2012) Early revision for isolated internal malrotation of the femoral component in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 20:1057–1063CrossRefPubMed Pietsch M, Hofmann S (2012) Early revision for isolated internal malrotation of the femoral component in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 20:1057–1063CrossRefPubMed
15.
go back to reference Pugh L, Ruel A, Lipman J, Wright T, Gessell M, Westrich G (2013) Reduction in bone volume resection with a newer posterior stabilized total knee arthroplasty design. HSS J 9:157–160CrossRefPubMedPubMedCentral Pugh L, Ruel A, Lipman J, Wright T, Gessell M, Westrich G (2013) Reduction in bone volume resection with a newer posterior stabilized total knee arthroplasty design. HSS J 9:157–160CrossRefPubMedPubMedCentral
16.
go back to reference Sassoon AA, Wyles CC, Norambuena Morales GA, Houdek MT, Trousdale RT (2014) Intraoperative fracture during aseptic revision total knee arthroplasty. J Arthroplasty 29:2187–2191CrossRefPubMed Sassoon AA, Wyles CC, Norambuena Morales GA, Houdek MT, Trousdale RT (2014) Intraoperative fracture during aseptic revision total knee arthroplasty. J Arthroplasty 29:2187–2191CrossRefPubMed
17.
go back to reference Ulivi M, Orlandini L, Meroni V, Consonni O, Sansone V (2015) Survivorship at minimum 10-year follow-up of a rotating-platform, mobile-bearing, posterior-stabilised total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 23:1669–1675CrossRefPubMed Ulivi M, Orlandini L, Meroni V, Consonni O, Sansone V (2015) Survivorship at minimum 10-year follow-up of a rotating-platform, mobile-bearing, posterior-stabilised total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 23:1669–1675CrossRefPubMed
18.
go back to reference Wragg R, Khan RJZ, Damasena ITW (2012) A comparison of bone loss at total knee replacement: posterior stabilized versus cruciate retaining. J Orthop 9:e1 Wragg R, Khan RJZ, Damasena ITW (2012) A comparison of bone loss at total knee replacement: posterior stabilized versus cruciate retaining. J Orthop 9:e1
Metadata
Title
Total and intercondylar notch bone resection in posterior stabilized knee arthroplasty: analysis of five manufacturer designs
Authors
Murat Bozkurt
Mesut Tahta
Safa Gursoy
Mustafa Akkaya
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3864-5

Other articles of this Issue 6/2017

Knee Surgery, Sports Traumatology, Arthroscopy 6/2017 Go to the issue