Resumen

VEDOYA, Santiago P; GARABANO, Germán  y  DEL SEL, Hernán. Indicación y resultados de la prótesis con estabilidad aumentada en la artroplastia primaria de rodilla. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2018, vol.83, n.2, pp.94-100. ISSN 1852-7434.

Introduction: The objective of this retrospective study was to show the functional results and indication criteria for prostheses for primary TKA with more constraint than posterior stabilization. Methods: Forty-three TKA were analyzed in 40 patients, with an average follow-up of 6.2 years. Preoperative diagnoses were valgus osteoarthritis (38 cases) and varus osteoarthritis (5 cases). Sufficiency of the collateral ligaments was classified as sufficient, attenuated or incompetent, through physical examination and X-rays with varus-valgus stress. Functional results were evaluated using the KSS. Results: Posterior-stabilized plus implants were used in 28 cases, with an average alignment of 15.9°: 26 were valgus knees, 21 of which presented sufficient and 5 attenuated ligaments. Constrained prostheses were used in 7 patients with an average valgus alignment of 21.6° (2 with sufficient and 5 with attenuated ligaments). Rotating-hinge prostheses were used in 8 patients, 5 with an average valgus alignment of 24.6° (3 of them associated with recurvatum), 4 with incompetent ligaments and one with attenuated ligaments. The average post-operative KSS was 84 (range 73-94) points. No instabilities were detected and prosthetic survival was 100% at the end of the follow-up. Conclusions: We recommend using posterior-stabilized plus implants in deformities <20°, with sufficient collateral ligaments and no bone defects; constrained prosthesis in patients with greater deformity (>20°) and collateral ligaments with some degree of sufficiency (attenuated at the most); and rotating-hinge implants in knees with collateral or multidirectional ligament insufficiency, associated with recurvatum, significant bone defects or severe deformities in rheumatoid arthritis or with neuropathic origin.

Palabras clave : Valgus; Recurvatum; Instability; Constrained prosthesis; Rotating-hinge implant.

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