RESEARCH PROGRESS OF DIFFERENCE BETWEEN HIGH-FLEXION PROSTHESIS AND CONVENTIONAL PROSTHESIS IN TOTAL KNEE ARTHROPLASTY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

RONGGenxiang ,  GUIBinjie , WANGSisheng

The First Orthopedic Ward, First Affiliated Hospital of Anhui Medical University, Hefei Anhui, 230022, P. R. China;

Corresponding author：

GUIBinjie, Email: guibinjie@163.com

Keywords：

High-flexion prosthesis; Conventional prosthesis; Total knee arthroplasty

DOI：

10.7507/1002-1892.20140024

Video：

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Objective To summarize the research progress of the difference between high-flexion prosthesis and conventional prosthesis in total knee arthroplasty, so as to offer a reference for clinical choice of prosthesis. Methods The relevant literature on high-flexion prosthesis and conventional prosthesis in recent years was extensively reviewed and analyzed. Results There are some controversies in range of motion and complications between high-flexion prosthesis and conventional prosthesis; while no obvious difference is found in knee function and satisfaction. Conclusion Comprehensive evaluation should be considered when high-flexion prosthesis is selected; and the effectiveness needs further follow-up.

Citation： RONGGenxiang, GUIBinjie, WANGSisheng. RESEARCH PROGRESS OF DIFFERENCE BETWEEN HIGH-FLEXION PROSTHESIS AND CONVENTIONAL PROSTHESIS IN TOTAL KNEE ARTHROPLASTY. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(1): 109-112. doi: 10.7507/1002-1892.20140024 Copy

1.	Rowe PJ,Myles CM,Walker C,et al.Knee joint kinematics in gait and other functional activities measured using flexible electrogoniometry:how much knee motion is sufficient for normal daily life? Gait Posture,2000,12(2):143-155.
2.	Laubenthal KN,Smidt GL,Kettelkamp DB.A quantitative analysis of knee motion during activities of daily living.Phys Ther,1972,52(1):34-43.
3.	Kettelkamp DB,Johnson RJ,Smidt GL,et al.An electrogoniometric study of knee motion in normal gait.J Bone Joint Surg (Am),1970,52(4):775-790.
4.	Park KK,Chang CB,Kang YG,et al.Correlation of maximum flexion with clinical outcome after total knee replacement in Asian patients.J Bone Joint Surg (Br),2007,89(5):604-608.
5.	Nakamura S,Takagi H,Asano T,et al.Fluoroscopic and computed tomographic analysis of knee kinematics during very deep flexion after totalknee arthroplasty.J Arthroplasty,2010,25(3):486-491.
6.	Ritter MA,Lutgring JD,Davis KE,et al.The effect of postoperative range of motion on functional activities after posterior cruciate-retaining total knee arthroplasty.J Bone Joint Surg (Am),2008,90(4):777-784.
7.	赵奇,蒋垚.人工膝关节假体设计新进展.中国组织工程研究与临床康复,2010,14(52):9838-9840.
8.	Malik A,Salas A,Ben Ari J,et al.Range of motion and function are similar in patients undergoing TKA with posterior stabilized and high-flexion inserts.Int Orthop,2010,34(7):965-972.
9.	Ritter MA,Harty LD,Davis KE,et al.Predicting range of motion after total knee arthroplasty.Clustering,log-linear regression,and regression treeanalysis.J Bone Joint Surg (Am),2003,85-A (7):1278-1285.
10.	Rajgopal V,Bourne RB,Chesworth BM,et al.The impact of morbid obesity on patient outcomes after total knee arthroplasty.J Arthroplasty,2008,23(6):795-800.
11.	Bin SI,Nam TS.Early results of high-flex total knee arthroplasty:comparison study at 1 year after surgery.Knee Surg Sports Traumatol Arthrosc,2007,15(4):350-355.
12.	Dennis DA,Komistek RD,Scuderi GR,et al.Factors affecting flexion after total knee arthroplasty.Clin Orthop Relat Res,2007,(464):53-60.
13.	Ranawat CS.Design may be counterproductive for optimizing flexion after TKR.Clin Orthop Relat Res,2003,(416):174-176.
14.	Sultan PG,Most E,Schule S,et al.Optimizing flexion after total knee arthroplasty:advances in prosthetic design.Clin Orthop Relat Res,2003,(416):167-173.
15.	Gupta SK,Ranawat AS,Shah V,et al.The P.F.C.sigma RP-F TKA designed for improved performance:a matched-pair study.Orthopedics,2006,29(9 Suppl):S49-52.
16.	Yoshiya S,Matsui N,Komistek RD,et al.In vivo kinematic comparison of posterior cruciate-retaining and posterior stabilized total knee arthroplasties under passive and weight-bearing conditions.J Arthroplasty,2005,20(6):777-783.
17.	Harato K,Bourne RB,Victor J,et al.Midterm comparison of posterior cruciate-retaining versus-substituting total knee arthroplasty using the Genesis Ⅱ prosthesis.A multicenter prospective randomized clinical trial.Knee,2008,15(3):217-221.
18.	Laskin RS.The effect of a high-flex implant on postoperative flexion after primary total knee arthroplasty.Orthopedics,2007,30(8 Suppl):86-88.
19.	Weeden SH,Schmidt R.A randomized,prospective study of primary total knee components designed for increased flexion.J Arthroplasty,2007,22(3):349-352.
20.	Dennis DA,Heekin RD,Clark CR.Effect of implant design on knee flexion.J Arthroplasty,2013,28(3):429-438.
21.	Kim YH,Sohn KS,Kim JS.Range of motion of standard and high-flexion posterior stabilized totalknee prostheses.A prospective,randomized study.J Bone Joint Surg (Am),2005,87(7):1470-1475.
22.	Thomsen MG,Husted H,Otte KS,et al.Do patients care about higher flexion in total knee arthroplasty? A randomized,controlled,double-blinded trial.BMC Musculoskelet Disord,2013,14:127.
23.	Seon JK,Park SJ,Lee KB,et al.Range of motion in total knee arthroplasty:a prospective comparison of high-flexion and standard cruciate-retaining designs.J Bone Joint Surg (Am),2009,91(3):672-679.
24.	Minoda Y,Aihara M,Sakawa A,et al.Range of motion of standard and high-flexion cruciate retaining total knee prostheses.J Arthroplasty,2009,24(5):674-680.
25.	Boese CK,Gallo TJ,Plantikow CJ.Range of motion and patient satisfaction with traditional and high-flexion rotating-platform knees.Iowa Orthop J,2011,31:73-77.
26.	Sumino T,Gadikota HR,Varadarajan KM,et al.Do high flexion posterior stabilised total knee arthroplasty designs increase knee flexion? A meta analysis.Int Orthop J,2011,35(9):1309-1319.
27.	Huang HT,Su JY,Wang GJ.The early results of high-flex total knee arthroplasty:a minimum of 2 years of follow-up.J Arthroplasty,2005,20(5):674-679.
28.	Luo SX,Su W,Zhao JM,et al.High-flexion vs conventional prostheses total knee arthroplasty:a meta-analysis.J Arthroplasty,2011,26(6):847-854.
29.	Mehin R,Burnett RS,Brasher PM.Does the new generation of high-flex knee prostheses improve the post-operative range of movement?:a meta-analysis.J Bone Joint Surg (Br),2010,92(10):1429-1434.
30.	Gandhi R,Tso P,Davey JR,et al.High-flexion implants in primary total knee arthroplasty:a meta-analysis.Knee,2009,16(1):14-17.
31.	Geller JA,Yoon RS,McKean J,et al.Does a highflexion design affect early outcome of medial unicondylar knee arthroplasty? Clinical comparison at 2 years.J Arthroplasty,2011,26(8):1468-1474.
32.	Wohlrab D,Hube R,Zeh A,et al.Clinical and radiological results of high flex total knee arthroplasty:a 5 year follow-up.Arch Orthop Trauma Surg,2009,129(1):21-24.
33.	Argenson JN,Komistek RD,Mahfouz M,et al.A high flexion total knee arthroplasty design replicates healthy knee motion.Clin Orthop Relat Res,2004,(428):174-179.
34.	Meftah M,Ranawat AS,Ranawat CS,et al.Safety and efficacy of a rotating-platform,high-flexion knee design three-to five-year follow-up.J Arthroplasty,2012,27(2):201-206.
35.	Miner AL,Lingard EA,Wright EA,et al.Knee range of motion after total knee arthroplasty:how important is this as an outcome measure? J Arthroplasty,2003,18(3):286-294.
36.	McCalden RW,MacDonald SJ,Bourne RB,et al.A randomized controlled trial comparing "high-flex" vs "standard" posterior cruciate substituting polyethylene tibial inserts in total knee arthroplasty.J Arthroplasty,2009,24(6 Suppl):33-38.
37.	Hamilton WG,Sritulanondha S,Engh CA Jr.Results of prospective,randomized clinical trials comparing standard and high-flexion posterior-stabilized TKA:a focused review.Orthopedics,2011,34(9):e500-503.
38.	Ranawat AS,Gupta SK,Ranawat CS.The P.F.C.sigma RP-F total knee arthroplasty:designed for improved performance.Orthopedics,2006,29(9 Suppl):S28-29.
39.	Coughlin KM,Incavo SJ,Doohen RR,et al.Kneeling kinematics after total knee arthroplasty:anterior-posterior contact position of a standard anda high-flex tibial insert design.J Arthroplasty,2007,22(2):160-165.
40.	Nagura T,Dyrby CO,Alexander EJ,et al.Mechanical loads at the knee joint during deep flexion.J Orthop Res,2002,20(4):881-886.
41.	Komistek RD,Kane TR,Mahfouz M,et al.Knee mechanics:a review of past and present techniques to determine in vivo loads.J Biomech,2005,38(2):215-228.
42.	Sharma A,Leszko F,Komistek RD,et al.In vivo patellofemoral forces in high flexion total knee arthroplasty.J Biomech,2008,41(3):642-648.
43.	Han HS,Kang SB,Yoon KS.High incidence of loosening of the femoral component in legacy posterior stabilised-flex total knee replacement.J Bone Joint Surg (Br),2007,89(11):1457-1461.
44.	Zelle J,Barink M,De Waal Malefijt M.Thigh-calf contact:does it affect the loading of the knee in the high-flexion range? J Biomech,2009,42(5):587-593.

1. Rowe PJ,Myles CM,Walker C,et al.Knee joint kinematics in gait and other functional activities measured using flexible electrogoniometry:how much knee motion is sufficient for normal daily life? Gait Posture,2000,12(2):143-155.
2. Laubenthal KN,Smidt GL,Kettelkamp DB.A quantitative analysis of knee motion during activities of daily living.Phys Ther,1972,52(1):34-43.
3. Kettelkamp DB,Johnson RJ,Smidt GL,et al.An electrogoniometric study of knee motion in normal gait.J Bone Joint Surg (Am),1970,52(4):775-790.
4. Park KK,Chang CB,Kang YG,et al.Correlation of maximum flexion with clinical outcome after total knee replacement in Asian patients.J Bone Joint Surg (Br),2007,89(5):604-608.
5. Nakamura S,Takagi H,Asano T,et al.Fluoroscopic and computed tomographic analysis of knee kinematics during very deep flexion after totalknee arthroplasty.J Arthroplasty,2010,25(3):486-491.
6. Ritter MA,Lutgring JD,Davis KE,et al.The effect of postoperative range of motion on functional activities after posterior cruciate-retaining total knee arthroplasty.J Bone Joint Surg (Am),2008,90(4):777-784.
7. 赵奇,蒋垚.人工膝关节假体设计新进展.中国组织工程研究与临床康复,2010,14(52):9838-9840.
8. Malik A,Salas A,Ben Ari J,et al.Range of motion and function are similar in patients undergoing TKA with posterior stabilized and high-flexion inserts.Int Orthop,2010,34(7):965-972.
9. Ritter MA,Harty LD,Davis KE,et al.Predicting range of motion after total knee arthroplasty.Clustering,log-linear regression,and regression treeanalysis.J Bone Joint Surg (Am),2003,85-A (7):1278-1285.
10. Rajgopal V,Bourne RB,Chesworth BM,et al.The impact of morbid obesity on patient outcomes after total knee arthroplasty.J Arthroplasty,2008,23(6):795-800.
11. Bin SI,Nam TS.Early results of high-flex total knee arthroplasty:comparison study at 1 year after surgery.Knee Surg Sports Traumatol Arthrosc,2007,15(4):350-355.
12. Dennis DA,Komistek RD,Scuderi GR,et al.Factors affecting flexion after total knee arthroplasty.Clin Orthop Relat Res,2007,(464):53-60.
13. Ranawat CS.Design may be counterproductive for optimizing flexion after TKR.Clin Orthop Relat Res,2003,(416):174-176.
14. Sultan PG,Most E,Schule S,et al.Optimizing flexion after total knee arthroplasty:advances in prosthetic design.Clin Orthop Relat Res,2003,(416):167-173.
15. Gupta SK,Ranawat AS,Shah V,et al.The P.F.C.sigma RP-F TKA designed for improved performance:a matched-pair study.Orthopedics,2006,29(9 Suppl):S49-52.
16. Yoshiya S,Matsui N,Komistek RD,et al.In vivo kinematic comparison of posterior cruciate-retaining and posterior stabilized total knee arthroplasties under passive and weight-bearing conditions.J Arthroplasty,2005,20(6):777-783.
17. Harato K,Bourne RB,Victor J,et al.Midterm comparison of posterior cruciate-retaining versus-substituting total knee arthroplasty using the Genesis Ⅱ prosthesis.A multicenter prospective randomized clinical trial.Knee,2008,15(3):217-221.
18. Laskin RS.The effect of a high-flex implant on postoperative flexion after primary total knee arthroplasty.Orthopedics,2007,30(8 Suppl):86-88.
19. Weeden SH,Schmidt R.A randomized,prospective study of primary total knee components designed for increased flexion.J Arthroplasty,2007,22(3):349-352.
20. Dennis DA,Heekin RD,Clark CR.Effect of implant design on knee flexion.J Arthroplasty,2013,28(3):429-438.
21. Kim YH,Sohn KS,Kim JS.Range of motion of standard and high-flexion posterior stabilized totalknee prostheses.A prospective,randomized study.J Bone Joint Surg (Am),2005,87(7):1470-1475.
22. Thomsen MG,Husted H,Otte KS,et al.Do patients care about higher flexion in total knee arthroplasty? A randomized,controlled,double-blinded trial.BMC Musculoskelet Disord,2013,14:127.
23. Seon JK,Park SJ,Lee KB,et al.Range of motion in total knee arthroplasty:a prospective comparison of high-flexion and standard cruciate-retaining designs.J Bone Joint Surg (Am),2009,91(3):672-679.
24. Minoda Y,Aihara M,Sakawa A,et al.Range of motion of standard and high-flexion cruciate retaining total knee prostheses.J Arthroplasty,2009,24(5):674-680.
25. Boese CK,Gallo TJ,Plantikow CJ.Range of motion and patient satisfaction with traditional and high-flexion rotating-platform knees.Iowa Orthop J,2011,31:73-77.
26. Sumino T,Gadikota HR,Varadarajan KM,et al.Do high flexion posterior stabilised total knee arthroplasty designs increase knee flexion? A meta analysis.Int Orthop J,2011,35(9):1309-1319.
27. Huang HT,Su JY,Wang GJ.The early results of high-flex total knee arthroplasty:a minimum of 2 years of follow-up.J Arthroplasty,2005,20(5):674-679.
28. Luo SX,Su W,Zhao JM,et al.High-flexion vs conventional prostheses total knee arthroplasty:a meta-analysis.J Arthroplasty,2011,26(6):847-854.
29. Mehin R,Burnett RS,Brasher PM.Does the new generation of high-flex knee prostheses improve the post-operative range of movement?:a meta-analysis.J Bone Joint Surg (Br),2010,92(10):1429-1434.
30. Gandhi R,Tso P,Davey JR,et al.High-flexion implants in primary total knee arthroplasty:a meta-analysis.Knee,2009,16(1):14-17.
31. Geller JA,Yoon RS,McKean J,et al.Does a highflexion design affect early outcome of medial unicondylar knee arthroplasty? Clinical comparison at 2 years.J Arthroplasty,2011,26(8):1468-1474.
32. Wohlrab D,Hube R,Zeh A,et al.Clinical and radiological results of high flex total knee arthroplasty:a 5 year follow-up.Arch Orthop Trauma Surg,2009,129(1):21-24.
33. Argenson JN,Komistek RD,Mahfouz M,et al.A high flexion total knee arthroplasty design replicates healthy knee motion.Clin Orthop Relat Res,2004,(428):174-179.
34. Meftah M,Ranawat AS,Ranawat CS,et al.Safety and efficacy of a rotating-platform,high-flexion knee design three-to five-year follow-up.J Arthroplasty,2012,27(2):201-206.
35. Miner AL,Lingard EA,Wright EA,et al.Knee range of motion after total knee arthroplasty:how important is this as an outcome measure? J Arthroplasty,2003,18(3):286-294.
36. McCalden RW,MacDonald SJ,Bourne RB,et al.A randomized controlled trial comparing "high-flex" vs "standard" posterior cruciate substituting polyethylene tibial inserts in total knee arthroplasty.J Arthroplasty,2009,24(6 Suppl):33-38.
37. Hamilton WG,Sritulanondha S,Engh CA Jr.Results of prospective,randomized clinical trials comparing standard and high-flexion posterior-stabilized TKA:a focused review.Orthopedics,2011,34(9):e500-503.
38. Ranawat AS,Gupta SK,Ranawat CS.The P.F.C.sigma RP-F total knee arthroplasty:designed for improved performance.Orthopedics,2006,29(9 Suppl):S28-29.
39. Coughlin KM,Incavo SJ,Doohen RR,et al.Kneeling kinematics after total knee arthroplasty:anterior-posterior contact position of a standard anda high-flex tibial insert design.J Arthroplasty,2007,22(2):160-165.
40. Nagura T,Dyrby CO,Alexander EJ,et al.Mechanical loads at the knee joint during deep flexion.J Orthop Res,2002,20(4):881-886.
41. Komistek RD,Kane TR,Mahfouz M,et al.Knee mechanics:a review of past and present techniques to determine in vivo loads.J Biomech,2005,38(2):215-228.
42. Sharma A,Leszko F,Komistek RD,et al.In vivo patellofemoral forces in high flexion total knee arthroplasty.J Biomech,2008,41(3):642-648.
43. Han HS,Kang SB,Yoon KS.High incidence of loosening of the femoral component in legacy posterior stabilised-flex total knee replacement.J Bone Joint Surg (Br),2007,89(11):1457-1461.
44. Zelle J,Barink M,De Waal Malefijt M.Thigh-calf contact:does it affect the loading of the knee in the high-flexion range? J Biomech,2009,42(5):587-593.

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RESEARCH PROGRESS OF DIFFERENCE BETWEEN HIGH-FLEXION PROSTHESIS AND CONVENTIONAL PROSTHESIS IN TOTAL KNEE ARTHROPLASTY

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