RHK versus conventional TKA in the treatment of post-traumatic knee OA after proximal tibial fracture.
Aandoening(en):
Knie
Specialist(en): Prof. Dr. Johan Bellemans, Dr. Jan Truijen
Introduction and purpose
TKA is considered an excellent procedure for the treatment of end stage primary osteoarthritis (OA). In post-traumatic OA however the results are usually less satisfying. The reasons for this are commonly attributed to the younger age of the patients, the post-traumatic damage to the bone and peri-articular soft tissues, and the compromised surgical environment secondary to the previously performed fracture treatment.
It is the author’s impression that the results in such cases are frequently better when a rotating hinge TKA (RHK) design is used. Rotating hinge designs offer superior stability compared to standard PS or CCK designs, provide greater rotational freedom, and allow better flexion-extension space mismatch.
It is therefore the aim to test the hypothesis that RHK designs provide better subjective and functional outcome than conventional TKA, when performed for post-traumatic OA after proximal tibial fractures.
Materials and methods
Matched-case observational study design.
All patients with TKA after ORIF for Schatzker type V and VI proximal tibial fractures (study group), comparing patients that underwent RHK type TKA versus conventional PS or CCK-type TKA (control group).
Matching is performed on the basis of fracture type, trauma mechanism, ORIF type, age, gender and BMI. The 3O best matched pairs (60 patients) will be further analysed for subjective, functional, and radiographic outcome using established scoring scales (KSS, KOOS, SF12 and WOMAC).
