Churl Hong Chun; Seok Hyun Kweon; Hyun Jun Kim; Ki Joon Jeong; Kwang Mee Kim

doi:10.4055/jkoa.2008.43.6.728

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Chun, Kweon, Kim, Jeong, and Kim: Revision Total Knee Arthroplasty using NexGen® LCCK with Allograft

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(6): 728-737.

Published online: 31 December 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.6.728

Revision Total Knee Arthroplasty using NexGen® LCCK with Allograft

Churl Hong Chun, M.D., Seok Hyun Kweon, M.D., Hyun Jun Kim, M.D., Ki Joon Jeong, M.D., Kwang Mee Kim^*

Department of Orthopedic Surgery, School of Medicine, Wonkwang University, Iksan, Korea.

^*Department of Medicine, Wonkwang University Graduate School, Institute of Wonkwang Medical Science, Iksan, Korea.

Address reprint requests to Churl Hong Chun, M.D. Department of Orthopedic Surgery, School of Medicine, Wonkwang University, 344-2, Shinyong-dong, Iksan 570-749, Korea. TEL: +82.63-859-1363, FAX: +82.63-852-9329, cch@wonkwang.ac.kr

Abstract

Purpose

To analyze the clinical and radiographic results after revision total knee arthroplasty (TKA) using Nexgen® LCCK (Legacy® knee constrained condylar knee, Zimmer, Warsaw, IN) with allograft.

Materials and Methods

Twenty patients (21 knees) taken revision TKA were analyzed. The average age of the patients was 69.2 years old and the average of follow-up duration was for 2 year to 8 years 2 months (average 3 years 5 months). The clinical result and radiographic measurements were assessed using the Hospital for Special Surgery (HSS) knee rating score and the roentgenographic method of the American Knee Society.

Results

The mean interval from TKA to revision surgery was 6 years 4 months. In all cases, allograft was used. The average range of motion was increased from 93° to 107°, HSS score was increased from an average of 45 to 87 points. Postoperative femorotibial alignment was averaged 5.7° valgus. In all cases, radiolucency was below 4 scores and there was no loosening of implant. But, three radiopaque lines around a stem. There were wound dehiscence in 1 case and superficial infection in 2 cases.

Conclusion

Satisfactory results were obtained in revision TKA using a NexGen® LCCK with allograft. But, this study is favorable for the long term follow-up.

Keywords: Knee, Revision arthroplasty, Nexgen® LCCK, Allograft

Figures and Tables

Fig. 1

72-year-old woman who undergone total knee arthroplasty in her left knee. (A) Preoperation radiography shows a septic loosening. (B) 1^st stage operation with use of static spacers and antibiotic impregnated bone cement beads. (C) Large bone defect in the distal femur (Anderson Orthopaedic Research Institute classification, T1/F2A). (D) At 2 years 9 months follow-up, radiograph shows the host-graft incorporation.

Fig. 2

70-year-old woman who undergone total knee arthroplasty in her left knee. (A) Preoperative radiograph shows aseptic loosening & osteolysis. (B) Large bone defect in the both femur, tibia sites (Anderson Orthopaedic Research Institute classification, T2A/F3). (C) At distal femur, the strut allograft-implant composite. (D) At 3 years 4 months follow-up, radiograph after revision surgery shows the structural allograft fixed to the proximal portion of tibia, distal femur and the incorporation of the structural allograft to the host bone junction.

Fig. 3

The zonal analysis of radiolucent lines around femoral and tibial components.

Table 1

Analysis of Patient Data

^*Anderson Orthopaedic Research Institute; ^†Distal Femur Allograft; ^‡Tibia; ^§Femur.

Table 2

AORI (Anderson Orthopaedic Research Institute) Classification

^*Anderson Orthopaedic Research Institute.

Table 3

Analysis of Clinical and Roentgenographic Data

^*Hospital for special surgery; ^†Range of Motion; ^‡Anteroposterior view; ^§Lateral view.

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