Mid-term clinical radiological results of the constrained condylar knee prosthesis in total knee revision

Eur J Orthop Surg Traumatol. 2024 May 17. doi: 10.1007/s00590-024-03977-9. Online ahead of print.

Abstract

Introduction: The aim of the present study is to analyze the clinical-radiological outcomes of patients undergoing knee prosthesis revision surgery using constrained condylar prosthesis (LCCK; Zimmer-Biomet).

Material and methods: Retrospective study of 89 patients operated on between the years 2008 and 2020 with a minimum of 2 years of follow-up. Clinical outcomes were evaluated using the WOMAC Index score and KOOS scales. Radiological results (radiolucent lines, osteolysis, and cortical hypertrophy) were evaluated by two independent observers. Implant survival was analyzed using the Kaplan-Meier method.

Results: At the end of follow-up, a mean WOMAC Index score of 78.67 and KOOS score of 68.8 were obtained. Radiolucent lines (both non-progressive and progressive) were detected in 83.3% of the patients in the sample. Areas of osteolysis > 5 mm around the components were present in 6.75%. Cortical hypertrophy was seen around the femoral stem in 20.3% of cases, around the tibial stem in 20.3% and around both components in 6.76%. No statistically significant relationship was found between the presence of radiolucent lines, osteolysis or cortical hypertrophy with functional results. Implant survival was 88.1% at 13 years.

Conclusion: The present study shows high survival of LCCK prosthesis in revision surgery. The progressive radiolucencies, were associated with worst clinical outcome.

Keywords: Clinical; Constrained; Knee; Prosthesis; Radiological; Revision.