A Systematic Review of Clinical Outcomes and Survivorship After Total Knee Arthroplasty With a Contemporary Modular Knee System

摘要

The SIGMA Knee Replacement System (DePuy-Synthes, Warsaw, Ind.), hereinafter termed the SIGMA knee, is a family of total knee arthroplasty (TKA) prostheses with a variety of configurations that accommodate several surgical philosophies and patient needs. Introduced in 1996, it is the product of the evolutionary development of TKA encompassing the Total Condylar Knee, The Insall Burstein Knee, and the original P.F.C Modular Knee System. The SIGMA knee includes fixed-bearing (FB), mobile-bearing (MB), cruciate-retaining (CR), cruciate-sacrificing, and posterior-stabilized (PS) prostheses, with high-flexion designs available with the FBs and MBs [1-4]. Within the system, the implants have a number of common design features, and many of the components are shared across the system [5-7]. On the femoral side, all the prostheses have the same multi-radius sagittal curve, coronal cross-section of the condyles, and patella flange [2,5,8]. The same tibial components can be used with the FB, CR, and PS designs [8]. Similarly, the MB tibial tray is the same for all configurations of the MB SIGMA knee implants [8]. The CR and PS-rotating-platform (RP) configurations of the SIGMA knee system use the same CR and PS femoral components as the FB-CR and PS configurations, respectively. Furthermore, much of the instrumentation and surgical technique is standardized [5,9].