Functional Performance with a Single-radius Femoral Design Total Knee Arthroplasty

Enrique Gómez-Barrena MD, PhD, Carmelo Fernandez-García MD, PhD, Almudena Fernandez-Bravo MD, Raquel Cutillas-Ruiz MD, Gloria Bermejo-Fernandez MD
Symposium: Current Issues in Knee Reconstruction
Volume 468, Issue 5 / May , 2009

Abstract

Background

Better muscular recovery of the extensor mechanism after TKA is claimed by femoral designs based on a sagittal single radius.

Questions/purposes

We aimed to compare postoperative knee performance through the Knee Society scores, flexor and extensor muscle function, stability, and gait of a series of patients receiving a posterior stabilized, cemented TKA, with a single-radius femoral design.

Methods

We compared a series of patients treated with a single-radius femoral design TKA to a simultaneous series of patients receiving a multiradius femoral design. Both groups were similar in demographics and preoperative Knee Society scores. The clinical pathways were identical. Outcome assessment included Knee Society scores, isokinetic assessment, stabilometry, and gait cycle analysis.

Results

We observed higher functional Knee Society scores (86.6 ± 1.89 versus 80.3 ± 1.90), fewer physiotherapy sessions (19.9 ± 4.65 versus 22.2 ± 3.34), and less time with two crutches (3.5 ± 1.2 versus 5.2 ± 1.04 weeks) for patients receiving the single-radius design. Isokinetic evaluation showed decreased flexion peak torque (40.3 ± 7.9 versus 48.7 ± 9.6), increased extension peak torque (77.2 ± 16.1 versus 69.1 ± 14.4), and lower flexor/extensor ratio (0.5 ± 0.08 versus 0.7 ± 0.1) in patients with the single-radius design. Stabilometry showing less relative oscillation, and gait cycle indirectly confirmed better support in the limb with the single-radius design.

Conclusions

The studied single-radius femoral design showed better functional short-term outcome and better extensor performance.

Level of Evidence

Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.