Modular Uncemented Tricompartmental Total Knee Arthroplasty:A Comparison between Posttraumaticand NonposttraumaticOsteoarthrosis

摘要

The incidence of posttraumatic osteoarthrosis, especially in younger patients, increases. In different studies total knee arthroplasty (TKA) is only indicated in 0-12% of cases of posttraumatic osteoarthrosis, because most authors feel that the indication for TKA in younger patients should be narrowly restricted. The most common indications for TKA include primary idiopathic osteoarthrosis and rheumatoid arthritis predominantly in patients > 60 years.In this prospective study a total of 188 patients with 197 TKAs were compared. 92 patients (93TKAs) had a posttraumatic osteoarthrosis, 96 patients (104TKAs) a nontraumatic osteoarthrosis. All patients received the same modulartricompartmental TKA in uncemented technique regarding femoral and tibial component.The patella was always cemented. All operations were performed by a group of six surgeons in a standardized operating technique.The evaluation of the study parameters included three components: patient questionnaire (pain, patient satisfaction, ability to walk, range of motion, workplace situation), clinical evaluation (Knee Society Clinical Rating Score), conventional X-ray, and CT evaluation (axial alignment, radiolucent lines, bone defects).In light of the results obtained in this study, TKA implantation appears to be a valid primary treatment option in young patients with posttraumatic ar-throsis. Even though the results for nearly all parameters were poorer in the posttraumatic osteoarthrosis group, the condition of these patients still improved significantly following TKA.