Total knee arthroplasty with Gemini MKII rotating-platform prosthesis

doi:10.3969/j.issn.2095-4344.2014.13.009

Abstract

Abstract:

BACKGROUND: Total knee arthroplasty mainly used fixed platform, but more and more movable platform was selected year by year in the clinic. Rotary platform theoretically can apparently improve the curative effects, but it has not been verified in the clinic.
OBJECTIVE: To summarize the design characteristics and clinical results of Gemini MKII (Link, Germany) rotary platform.
METHODS: From January 2004 to January 2009, 108 patients (119 knees) including 31 males and 77 females were treated with total knee arthroplasty by using Gemini MKII system. There were 97 unilateral cases and
11 bilateral cases at the first stage of replacement. Preoperative diagnosis: 1 case of hemophilic arthritis, 1 case of venereal Charcot’s disease, 8 cases of post-traumatic arthritis, 11 cases of rheumatoid arthritis, and 87 cases of degenerative osteoarthritis. The prosthesis was fixed with bone cement. None received patellar replacement.
RESULTS AND CONCLUSION: None experienced infection, femoral condyle fracture or nerve and vascular damage. Except bilateral replacement, the average operation time of unilateral replacement was (56±13) minutes. Average postoperative hemoglobin decreased (25±5) g/L. After replacement, hemoglobin maintained over
100 g/L in 83 patients (86%), without blood transfusion. Knee joint score and function score recovered to (92.0±4.7) points and (90.3±6.8) points at half years after replacement, and became (94.4±3.2) points and (91.6±5.9) points during final follow-up, which was significantly improved as compared with that pre-replacement (P < 0.01). No revision surgery should be done for lining prolapse or spin out, osteolysis and prosthesis loosening. These results indicated that the early and midterm results of Gemini MKII rotating-platform prosthesis were satisfactory, but the long-term results remain to be confirmed.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: arthroplasty, replacement, knee, prosthesis design, treatment outcome, postoperative complications

CLC Number:

R318

Wang Qiang, Sun Jun-ying, Xue Feng, Sheng Xiao-wen, Peng Yu-qin. Total knee arthroplasty with Gemini MKII rotating-platform prosthesis[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(13): 2018-2023.

Figures/Tables 2

References

[1] Yoon HS, Han CD, Yang IH. Comparison of simultaneous bilateral and staged bilateral total knee arthroplasty in terms of perioperative complications. J Arthroplasty. 2010;25(2): 179-185.

[2] Raviraj A, Chakravarthy M, Pai S, et al. Comparison of simultaneous bilateral and staged bilateral total knee arthroplasty in terms of perioperative complications. J Arthroplasty. 2011;26(1):165-166.

[3] Ritter MA, Berend ME, Meding JB, et al.Long-term followup of anatomic graduated components posterior cruciate- retaining total knee replacement. Clin Orthp. 2001;388: 51-57.

[4] Dennis DA, Clayton ML, O’Donnell S, et al. Posterior cruciate condylar total knee arthroplasty: average 11-year follow-up evaluation. Clin Orthop Relat Res. 1992;281: 168-176.

[5] Aigner C, Windhager R, Pechmann M, et al. The influence of an anterior-posterior gliding mobile bearing on range of motion after total knee arthroplasty: a prospective, randomized,double-blinded study. J Bone Joint Surg Am. 2004;86:2257-2262.

[6] Dixon MC, Brown RR, Parsch D, et al. Modular fixed-bearing total knee arthroplasty with retention of the posterior cruciate ligament. A study of patients followed for a minimum of fifteen years. J Bone Joint Surg Am. 2005;87:598-603.

[7] Schai PA, Thornhill TS, Scott RD. Total knee arthroplasty with the PFC system: results at a minimum of ten years and survivorship analysis. J Bone Joint Surg Br. 1998;80: 850-858.

[8] Sharkey PF, Hozack WJ, Rothman RH, et al. Why are total knee arthroplasties failing today? Clin Orthop Relat Res.2002; 404:7-13.

[9] Dennis DA,Komjslek RD.Mobile-bearing total knee artbroplasty:design factors in minimizing wear. Clin Orthop Relat Res. 2006;(452):70-77.

[10] Buechel Sr FF, Buechel Jr FF, Pappas MJ, et al. Twenty-year evaluation of meniscal bearing and rotating platform knee replacements. Clin Orthop. 2001;388:41-50.

[11] Duffy GP, Trousdale RT, Stuart MJ. Total knee arthroplasty in patients 55 years old or younger. 10-to 17-year results.Clin Orthop Relat Res.1998;356: 22-27.

[12] Crowder AR, Duffy GP, Trousdale RT. Long-term results of total knee arthroplasty in young patients with rheumatoid arthritis. J Arthroplasty. 2005;20(Suppl 3):12-16.

[13] Aglietti P, Baldini A, Buzzi R, et al. Comparison of mobile-bearing and fixed-bearing total knee arthroplasty. J Arthroplasty.2005;20(2):145-153.

[14] Hartford JM, Hunt T, Kaufer H. Low contact stress mobile bearing total knee arthroplasty: Results at 5 to 13 years. J Arthroplasty. 2001;16(8): 977-983.

[15] Healy WL, Iorio R, Warren P. Mesh expansion release of the lateral patellar retinaculum during total knee arthroplasty. J Bone Joint Surg Am. 2004;86-A Suppl 1(Pt 2):193-200.

[16] 曾金才,孙俊英,杨立文,等.关节内置管局部浸润镇痛在全膝关节置换术的应用[J].中国矫形外科杂志,2009,17(21):1609-1612.

[17] Insall JN, Dorr LD, Scott RD, et al. Rationale of the Knee Society Clinical Rating System. Clin Orthop. 1989;248:13-14.

[18] Ewald FC. The knee society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop. 1989;248:9-12.

[19] Buechel FF, Pappas MJ. New Jersey low contact stress knee replacement system. Orthop Clin North Am. 1989;20(2): 147-177.

[20] Parks NL, Engh GA, Topoleski LD, et al. The Coventry Award. Modular tibial insert micromotion. A concern with contemporary knee implants. Clin Orthop. 1998; 356:10-15.

[21] Bell CJ, McEwen HM. Comparision of wear in fixed and mobile-bearing knee designs. Transactions of: The 49th Annual Meeting of the Orthopaedic Research Society. New Orleans, La. 2003.

[22] Dennis DA, Komistek RD. Mobile-bearing total knee arthroplasty. Clin Orthop. 2006;452:70.

[23] Fisher J, Mcewen H, Tipper J, et al. Wear-simulation analysis of rotating-platform mobile-bearing knees. Orthopedics. 2006; 29(9)supplement:S36-S41.

[24] Ho FY, Ma HM, Liau JJ, et al. Mobile-bearing knee reduce rotational asymmetric wear. Clin Orthop. 2007;462:143-149.

[25] Ali MS, Mangaleshkar SR. Uncemented rotating-platform total knee arthroplasty. J Arthroplasty. 2006;21(1):80-84.

[26] Rand JA, Trousdale RT, Ilstrup DM, et al. Factors affecting the durability of primary total knee prostheses. J Bone Joint Surg. 2003;85A:259.

[27] Bert JM. Disclocation/subluxation of meniscal bearing elements after New Jersey Low-ContactStress Total Knee Arthroplasty. Clin Orthop. 1990;254: 211-215.

[28] Hartford JM, Harned ME, Kaufer H, et al. Primary meniscal-bearing knee replacements. Clin Orthop. 2007; 465:227-231.

[29] Huang CH, Young TH, Lee YT, et al. Polyethylene failure in New Jersey low-contact stress total knee arthroplasty. J Biomed Mater Res. 1998;39:153-160.

[30] Weaver JK, Derkash RS, Greenwald AS. Difficulties with bearing dislocation and breakage using a movable bearing total knee replacement system. Clin Orthop. 1993;290: 244-252.

[31] Westrich GH, Agulnick MA, Laskin RS, et al. Current analysis of tibial in total knee arthroplasty. Knee. 1997;4:87-91.

[32] 汪强.采用Gemini MKⅡ旋转活动平台假体行全膝关节置换术的临床疗效[D]. 苏州大学,2012.

[33] 伍旭辉,肖扬,黄暾昇,等. GEMINI MKⅡ微创技术在胫骨高位截骨术后患者膝关节置换中的应用及临床研究[J].中国医药导报, 2013,10(20)：43-45.

[34] 沈锋,王谦, 黄建明,等. GEMINI MKⅡ全膝关节置换术的临床应用[J]. 中国骨与关节损伤杂志, 2010,25(3):207-210.

[35] 王晓峰,陈百成,师晨霞,等. 固定平台型和移动平台型假体全膝关节置换术后临床效果的分析比较[J]. 中国矫形外科杂志, 2007,15(18):1367-1370.

[36] 曾金才,孙俊英,杨立,等.关节内置管局部浸润镇痛在全膝关节置换术的应用[J].中国矫形外科杂志,2009,17(21):1609-1612.

[37] 张健,董纪元,付忠田.国人膝关节尺寸与5种人工膝关节假体尺寸的对照[J].中国组织工程研究与临床康复,2009, 13(4): 635-638.

[38] 田孟强,刘军,张宇,等.全膝关节置换手术相关并发症探讨[J].中国修复重建外科杂志,2009,23(1):55-59.