Follow-up of High-flexion versus Conventional Total Knee Art
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High-flexion total knee arthroplasty (HF-TKA) prostheses were designed with hopes of improving knee function. Studies have suggested increased failure with HF-TKAs. The purpose is to compare clinical results of HF-TKA versus conventional TKA (C-TKA) from the same implant system with long-term follow-up.

This review of prostheses implanted, matched 145 of 179 possible HF-TKAs with 145 of 1,347 possible C-TKAs. Mean follow-up was 121.5 ± 20.3 months. Researchers were unable to match 12 HF-TKAs. HF-TKAs with less than 8-year follow-up were excluded. The primary outcome was failure requiring revision. Secondary outcomes included range of motion (ROM), Knee Society Scores (KSS), and radiolucent lines.

--In the matched cohort, there were 15 HF-TKA reoperations, 8 of which involved component revisions.

--There were 12 reoperations in the C-TKA cohort but no component revisions.

--Analysis of the unmatched cohorts revealed a higher revision rate for HF-TKAs (HF-TKA: 10/179 vs C-TKA: 27/1347).

--At final follow-up, HF-TKAs exhibited more prosthesis radiolucent lines without evidence of loosening.

--Particularly, HF-TKAs demonstrated more femoral zone IV radiolucencies (38.7%) at final follow-up compared to C-TKAs (13.8%). There were no differences found between cohorts in ROM or KSS.

Finally, in the matched and unmatched review, this research revealed an increased incidence of failure requiring revision with HF-TKA. Higher radioactive line incidences of HF-TKA have been detected. There appears to be little benefit in the use of the HF-TKA without seen variations in ROM and KSS and with a higher failure rate of HF-TKA.