title: Patient-Specific Total Knees Demonstrate a Higher Manipulation Rate Compared to "Off-the-Shelf Implants".
abstract: Patient-specific total knee replacements have been designed in hopes of providing better functional outcomes compared to "off-the-shelf" implants in primary total knee arthroplasty (TKA). We prospectively evaluated manipulation rates and clinical outcomes of 21 patient-specific TKAs matched with 42 posterior-stabilized and 11 cruciate-retaining "off-the-shelf" TKAs. Postoperatively, the patient-specific group had a range of motion significantly less than both control groups (P<0.01). Six of the 21 (28.6%) patient-specific TKAs required manipulation to improve range of motion. No manipulations were reported in either control groups. At minimum two-year follow-up the patient-specific TKAs had similar motion, but worse satisfaction and KSS pain scores. Radiographic analysis provided no insight to the cause of stiffness. Early manipulation is recommended for stiffness with patient-specific TKA.
authors: Hospital for Special Surgery, NY, New York.
authors: Peter B
authors: PB
authors: White
authors: Hospital for Special Surgery, NY, New York.
authors: Amar S
authors: AS
authors: Ranawat
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D017060:Patient Satisfaction; D020959:Polyethylene / Q000737:chemistry; D011184:Postoperative Period; D011446:Prospective Studies; D011474:Prosthesis Design / Q000379:methods*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D020959:Polyethylene
keywords: manipulation; patient-specific; range of motion; technology; total knee arthroplasty