J Korean Orthop Assoc.  2011 Apr;46(2):114-121.

Outcome of Isolated Tibial Polyethylene Insert Exchange after Total Knee Arthroplasty

• Chun CH
• Kim JW
• Kweon SH
• Choi BS
• Chun KC

Abstract

PURPOSE
We investigated the short term outcomes of isolated tibial polyethylene insert exchange after revision total knee arthroplasty.
MATERIALS AND METHODS
We selected 18 cases from 17 patients among the 20 cases from 19 patients who took isolated tibial polyethylene insert exchange after mean 69 months-follow up of TKA, which was carried out from June 1991 to August 2003. Two cases were excluded on account of loss to follow-up. In all cases, isolated tibial polyethylene insert exchange was carried out from May 1998 to October 2008 in our institute and the mean follow-up period after operation was 48 (22-142) months. We evaluated the following clinical and radiologic aspects: range of motion, HSS score, average labor time, and BMI. Together, these factors were used in clinical evaluation while femorotibial angle and radiolucent line were used in radiologic evaluation.
RESULTS
The average range of motion was 110.6 degrees and HSS score was 86.9 in follow up period. The average femorotibial angle was valgus 5.3degrees. The average labor time was 9.7 hours and BMI was 25.9. Although radiolucent line was found in 4 cases, there were all confirmed to be non progressive lesion less than 2 mm. Survival rate was 100% in Kaplan-Meier survival analysis.
CONCLUSION
Selective isolated tibial polyethylene insert exchange can be the successful method for revision TKA in limited cases.

Keyword

revision total knee arthroplasty; polyethylene insert exchange

MeSH Terms

Arthroplasty
Follow-Up Studies
Humans
Knee
Polyethylene
Range of Motion, Articular
Survival Rate
Polyethylene

Figure

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  Figure 1 Intraoperative photographs show severely extended synovitis.

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  Figure 2 (A) Anteroposterior and lateral radiographs of TKA knee before revision. (B) Well aligned and well fixed femoral component. (C) Well aligned and well fixed tibial component. (D) Wear of meniscal bearing is located mainly in medioposterior surface area. (E) Postoperative anteroposterior and lateral radiographs show regular joint space after isolated tibial insert change.

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  Figure 3 Partition system used for separating components into sections for grading of damage.

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