Abstract:
BACKGROUND:The purpose of this study was to evaluate long-term clinical and radiological results as well as survival rates of the NexGen® CR posterior cruciate retaining prosthesis. PATIENTS AND METHODS:We evaluated a consecutive series of 761 total knee replacements performed on 716 patients from 1999 to 2001 at our institution. All patients had been recorded prospectively in our in-house arthroplasty register. Follow-up data were available for 379 patients at 10 years postoperatively. Functional outcome was evaluated using the Knee Society score. An additional radiographic evaluation was performed on 224 patients at 10 years. The mean age of the patients at the time of surgery was 71 years. 75 % of the patients were female, 25 % were male. Mean BMI of the patients was 29.2 kg/m(2). The preoperative diagnosis was osteoarthritis in 91 %, rheumatoid arthritis in 5,5 % and posttraumatic osteoarthritis in 2 %. Patella resurfacing was performed in 4 %. All components were cemented. RESULTS AND DISCUSSION:Mean Knee Society clinical score improved from 26.7 points preoperatively to 88.5 points at the time of the latest follow-up, and mean Knee Society function score improved from 48.3 to 55.2 points. Flexion improved from a mean of 106.7° preoperatively to 111.4° at 10 years. Patellofemoral pain was indicated by 66 % of the patients before surgery and 4 % at the latest follow-up. 96 % were satisfied with the result of the surgery at 10 years. Radiographic evaluation was performed on 224 patients at the time of the latest follow-up. 203 patients (91 %) had normal radiographic findings, 21 patients (9 %) showed pathological findings. Radiolucencies were seen in 18 patients on the AP view of the tibia, 1 patient had an additional femoral radiolucency. There was an osteolysis located in the lateral tibia seen in 1 patient and an occurrence of heterotopic ossification in another patient. One knee showed a patella subluxation. No patient had radiographic evidence of loosening. 17 knees had required revision surgery with exchange of at least one of the components up to 10 years after the index procedure. 5 of the patients had revision for a deep infection, 2 for periprosthetic fractures of the distal femur with loosening of the prosthesis, 1 for fracture of the proximal tibia due to osteoporosis, 4 for aseptic loosening, 3 for instability and 2 for severe pain. Kaplan-Meier survival of all components using revision for any reason as the end point was 97.8 % at 10 years. CONCLUSION:The good clinical and radiological long-term results as well as the satisfactory survival rate after total knee replacement with the NexGen CR® prosthesis are comparable with the results of other long-term studies using the NexGen CR® and assimilable prosthesis. Our results demonstrate that quality of life was improved by the implantation of the NexGen CR® prosthesis even a long time after the index procedure despite old age and comorbidity of the patients.
journal_name
Z Orthop Unfalljournal_title
Zeitschrift fur Orthopadie und Unfallchirurgieauthors
Hack J,Mai S,Siebert Wdoi
10.1055/s-0035-1546040subject
Has Abstractpub_date
2015-10-01 00:00:00pages
508-15issue
5eissn
1864-6697issn
1864-6743journal_volume
153pub_type
临床试验,杂志文章abstract::In recent years, increasing concern has been raised regarding potential systemic toxicity of metals released from arthroplasty implants. A lack of valid metal thresholds for human (organ) toxicity and the prospect of multi-decade survival of modern hip and knee replacements pose special challenges. Indeed, evidence of...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-1187-1751
更新日期:2020-10-01 00:00:00
abstract:AIM:Whole body spiral CT scans have become a routine method in the radiological imaging of severely injured patients in emergency rooms of an increasing number of hospitals. The routine use of CT scans is, however, still discussed controversially, especially with regard to its use in children. This is mainly due to the...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-989438
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Hallux valgus is one of the most prevalent foot deformities, and surgical treatment of Hallux valgus is one of the most common procedures in foot and ankle surgery. Diagnostic and treatment standards show large variation despite medical guidelines and national foot and ankle societies. The aim of this nation...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-120352
更新日期:2018-04-01 00:00:00
abstract:INTRODUCTION:Lawn mower injuries in children usually involve the lower extremities and can lead to serious amputation injuries. Treatment should look not only at the acute reconstruction, but also on maintaining the ability to grow. We report the case of a two-year-old boy with amputation of the heel. CASE REPORT:The ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0031-1298260
更新日期:2012-04-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to evaluate the long term results of joint preserving surgery with hamstring release and dorsal capsulotomy for the treatment of therapy resistant knee flexion contracture in patients with severe haemophilia. METHODS:16 patients having undergone hamstring release and dorsal capsu...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-965228
更新日期:2007-05-01 00:00:00
abstract::During the last years, the prosthetic replacement in upper limb amputees has undergone different developments. The use of new nerve surgical concepts improved the control strategies tremendously, especially for high-level amputees. Technological innovation in the field of pattern recognition enables the control of mul...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-108910
更新日期:2016-08-01 00:00:00
abstract:AIM:Problems with the patellofemoral joint are still one of the most common difficulties after total knee arthroplasty. One of the main reasons for these problems seems to be the rotatory malposition of the femoral component. We examined the rotation of the femoral component and the symmetry of the flexion gap of knee ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1240587
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Total hip and knee replacements are very frequently performed operative procedures in German hospitals. Despite the high number of cases, only few data on treatment procedures of the clinical routine and their impact on postoperative length of stay and clinical outcome are available. The aim of our survey wa...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0034-1383023
更新日期:2014-10-01 00:00:00
abstract::Acute compartment syndrome of the lower leg following computer navigated primary total knee arthroplasty is rare but potentially devastating. This could be triggered by a setting of the bicortical tibial navigation pin. It is essential to take care during the operation, and to implement close post-operative control, e...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-1295-0249
更新日期:2020-12-17 00:00:00
abstract:INTRODUCTION:The mechanical properties of acrylic bone cements are an important factor in determining an efficient load transmission between prosthesis and bone to guarantee the long-term stability in cemented hip arthroplasty. MATERIAL AND METHODS:Palacos and Refobacin Palacos specimens from 21 aseptically loosened f...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-989324
更新日期:2008-01-01 00:00:00
abstract::Surgical principles for treatment of full-thickness cartilage defects of the knee include bone marrow stimulation techniques (i.e. arthroscopic microfracturing) and transplantation techniques (i.e. autologous chondrocyte implantation and osteochondral transplantation). On the basis of increasing scientific evidence, i...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 共识发展会议,杂志文章,评审
doi:10.1055/a-0591-6457
更新日期:2018-10-01 00:00:00
abstract:AIM:The aim of this study was to investigate hyaline cartilage defects treated with cell-seeded artificial matrix systems (two different collagen type I gels) with the method of optical coherence tomography (OCT) and to correlate the results with conventional histological and immunocytochemical staining. METHOD:Osteoc...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038948
更新日期:2008-11-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate peri- and postoperative complications and the clinical/radiological results after hip resurfacing with the ASR prosthesis in patients with osteoarthritis. METHOD:A prospective cohort study was performed including all patients who received a hip resurfacing (ASR prosthe...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038397
更新日期:2008-03-01 00:00:00
abstract::Background: Ankle fractures are extremely common in the elderly, with an incidence of up to 39 fractures per 100,000 persons per year. We found a discrepancy between intraoperative findings and preoperative X-ray findings. It was suggested that many relevant lesions of the ankle joint in the elderly cannot be detected...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-113879
更新日期:2017-02-01 00:00:00
abstract::Background Medical curricula require an increasing amount of integrated clinical practical skills education. German medical faculties are increasingly implementing the OSCE (objective structured clinical examination) to test students' practical as well as communication skills. Teaching and assessment tools for practic...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-0043-109022
更新日期:2017-08-01 00:00:00
abstract::In Germany and other European countries, cancer is the second most common cause of death after cardiovascular disease. Although 5-year survival rates for several types of cancer have significantly improved over the last 30 years, metastasis to the bone almost always leads to incurable disease. Aside from the rare prim...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0043-116799
更新日期:2017-12-01 00:00:00
abstract:AIM:Loosening of the glenoid component is one of the major causes of failure in total shoulder arthroplasty. Possible risk factors for loosening of cemented components include an eccentric loading, poor bone quality, inadequate cementing technique and insufficient cement penetration. The application of a modern cementi...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0030-1249986
更新日期:2010-12-01 00:00:00
abstract::Background: The perception of back pain subjective is hard for physicians to measure. For this reason, questionnaires are an important instrument to evaluate the pain 1. The main point of this study was to verify differentiation of pain symptoms in patients with different pain mechanisms. The most important parameter ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-108063
更新日期:2016-12-01 00:00:00
abstract:INTRODUCTION:Trauma or infectious diseases can cause destruction of the epiphyseal region of the knee with premature partial bridging of the physis and deviation of length and axis. There is only little information about tumorous lesions as pathogenetic factor for these deviations. We have been searching for an approac...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038999
更新日期:2008-11-01 00:00:00
abstract::Background: Placing transpedicular screws in the cervical spine is a special challenge for spine surgeons, due to the anatomical features of this part of the spine. During the last 15 years, computer-aided navigation systems have been developed to facilitate this procedure and to make it safer for patients. One option...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-105957
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Postarthroscopic glenohumeral chondrolysis (PAGCL) is a rare complication of shoulder arthroscopy. PAGCL describes a chondrolysis in the shoulder joint after arthroscopy mostly affecting younger patients. The process leading to chondrolysis is not known yet. MATERIAL AND METHODS:The case report describes a ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0030-1270919
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:The concept of combined anteversion for total hip arthroplasty (THA) proposes a relationship between the cup and stem components that theoretically maximises the postoperative range of motion and minimises the risk for impingement of the joint. Using computer-assisted navigation tools, an anteversion angle o...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1240969
更新日期:2010-03-01 00:00:00
abstract::The present refresher article highlights the current role of pedicled flaps in the reconstruction of complex wounds at the lower extremity. Due to the increasing standardization and ongoing improvements in microsurgery and in view of the fact that local tissue limitation and elevated rates of wound healing disorders r...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-124091
更新日期:2019-02-01 00:00:00
abstract::Fractures of the scapula are rare and have an incidence of 1% of all fractures. Publications highlight glenoid rim fractures. Classification by Ideberg and Euler and Rüdi are accepted. Euler and Rüdi describe three extra-articular and two intra-articular fracture patterns. The indications for surgery are displaced gle...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-0576-2036
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:In the late 1960s, the helicopter emergency medical service (HEMS) was established in Germany because of an increasing number of severe injuries in traffic accidents. To get a doctor quickly on scene was the initial intention, rather than transporting the patient. Today, rescue helicopters cover the entire f...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1545801
更新日期:2015-08-01 00:00:00
abstract::Cement-augmented pedicle screws can increase the stability of fixators for unstable vertebral fractures in the elderly. Fixators can be inserted quickly and with minimally invasive techniques, reducing surgical risks. From March 2012 until July 2014, we treated 40 patients with percutaneous augmented fixators for unst...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-111594
更新日期:2017-10-01 00:00:00
abstract::Soft tissue injury in total hip replacements has recently developed into a main topic of orthopaedic surgery. The M. glutaeus medius is at risk to be injured in Watson-Jones' approach to the hip. A special technique in positioning of the leg offers the possibility to save the integrity of the muscles. While profiling ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0034-1368207
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the impact of students preexisting anatomic proficiency to address the fundamental problems related to musculoskeletal ultrasound (MSUS) training by assessing the peer-assisted learning (PAL) system. METHODS:Students without anatomic knowledge (first semester, n = 38) an...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0030-1250378
更新日期:2010-12-01 00:00:00
abstract::The main reason for total hip arthroplasty (THA) revision is the wear-related aseptic loosening. Younger and active patients after total joint replacement create high demands, in particular, on the bearings. The progress, especially for alumina ceramic-on-ceramic bearings and mixed ceramics have solved many problems o...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1545802
更新日期:2015-04-01 00:00:00
abstract:AIMS:The combination of a distal tibia fracture with an additional upper ankle joint injury is a challenge. Apart from various implants the intraoperative problem is the handling of these two injuries with appropriate reduction and retention. The existing and further developing soft tissue damage has to be taken into c...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1039265
更新日期:2009-05-01 00:00:00