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Condylar constrained system in primary total knee replacement: our experience and literature review.

Research paper by Luigi L Sabatini, Salvatore S Risitano, Lorenzo L Rissolio, Andrea A Bonani, Francesco F Atzori, Alessandro A Massè

Indexed on: 04 May '17Published on: 04 May '17Published in: Annals of translational medicine



Abstract

Constrained condylar knee (CCK) prosthesis are common used for revision surgery but can also help surgeons to improve implant stability in primary knee arthroplasty, in fact in severe knee arthrosis with serious deformity associated with a significant instability a more constrained articulation is required. With introduction of second generation of semi-constrained prosthesis, rate of complication is real decreased and a good survival rate and functional score results is showed. In this paper we write about our experience using CCK in primary knee arthroplasty.Between January 2012 and December 2015, 28 second-generation semi-constrained knee arthroplasties were performed as a first implant. Two different types of implants were used: 10 constrained condylar knee (CCK Zimmer) and 18 TC3 (DePuy Johnson & Johnson). All patients were over 75 years old (mean 81.75) with a severe deformity and clinical evaluations at 2-, 6-, 12-month after surgery and every year performed. X-rays at 6, 12 months and then annually was planned with an average follow-up of 31.28 (range 6-48) months.No patients were lost during the follow-up. The mean functional knee society score (KSS) improved from 30 points preoperatively to 92.1 points at the last follow-up. All patients recovered full extension during follow-up and no radiolucent lines were showed at X-ray control. There were no deep infections or peri-prosthetic fractures.Second generation semi-constrained knee prosthesis represent safe and practical treatment in primary total knee arthroplasty (TKA) in case of severe deformity that can't be managed with accurate soft tissue release, especially in elderly patients.