Clinical evaluation of the I/B total condylar knee system type II(PS type) in rheumatoid and osteoarthritic patients.
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The functions of the knee and radiographical changes were analyzed in 30 consecutive patients with 46 posterior stabilized condylar knee prostheses. The patients were followed for an average of 1.6 years (range, l to 2.6 years) .<BR>Scores in each item of the knee function rating except range of motion increased significantly after surgery. Flexion contractures and femorotibial angles were significantly improved, but the average degrees of flexion and ranges of motion were the same after operation as before. All these results except pain were significantly correlated with the preoperative state. Relief of pain was successfully achieved regardless of the preoperative degree of pain. Good flexion arcs were correlated with posterior positioning of the tibial prostheses.<BR>Nine knees (19.6%) had radiolucent zones at the bone-cement interface. Data analysis of age, degree of obesity, knee function score, postoperative range of motion, postoperative femorotibial angle, tilting of components, and positioning of components demonstrated no statistically significant characteristic of this group in comparison with the group without radiolucent zones. The only factor that correlated with the presence of radiolucent zones was tibial cementing length, i.e., the vertical distance from the tip of the tibial central peg to the distal end of the cement. The average tibial cementing length of the knees without radiolucent zones was 26.2 mm, which was significantly longer than the 10.0 mm of the knees with radiolucent zones.<BR>Comparison of the 12 knees in 8 rheumatoid patients with 38 knees in osteoarthritic patients indicated that the arthroplasty relieved joint pain and improved the range of motion more successfully in rheumatoid knees than in osteoarthritic knees. However, the RA patients scored worse than the patients with osteoarthritic postoperatively in the categories of gait and daily activities, in which involvement of other joints was probably the major obstacle.
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