FUNCTIONAL OUTCOME OF TOTAL KNEE REPLACEMENT USING INDUS PROSTHESIS Dr. L.k.lelei Specialist orthopedic surgeon Moi university, school of medicine

 Osteoarthritis is a primary source of disability and the knee joint is commonly affected.  Total knee arthroplasty (TKA) is the most frequently performed joint replacement surgery.  Its one of the most successful orthopedic surgeries.  The best results for TKR at years compare to or surpass the best result of THR. Introduction

I.Increasing age II.Obesity III.Female gender IV.Trauma\infection V.Repetitive occupational trauma The clinical features depends upon stage of involvement: PainStiffness Loss of functionDeformity SwellingCrepitus Risk factors for OA

 Non pharmacologic  Pharmacologic  NSAIDs  Glucosamine sulphate  Intra articular corticosteroids  Intra articular hyaluronic acid Surgical interventions: Arthroscopy Osteotomy Total knee replacement Conservative management of knee OA

 Regular pain needing constant medication  Deformity of the knee  Flexion contracture > 20 degrees  Severe varus or valgus laxity  Night pain, getting up pain  Altered social or family life due to pain Indications for TKR

Technical goals of TKR include:  The restoration of mechanical alignment  Preservation or restoration of the joint line  Ligament balancing  Maintaining or restoring a normal angle. Goals of TKR

 Relief pain  Improve joint alignment  Treat joint deformity  Improve knee stability  Regain joint strength  Improve mobility Benefits of total knee replacement

 Successful results depends upon: i.Precise surgical technique ii.Sound implant design iii.Appropriate material iv.Patient compliance with rehabilitation The long term survival of total knee replacement equals or surpasses that of THR.

 Current knee prosthesis design trends focus on shortening the radii of curvature  The INDUS prosthesis is designed so as to keep the thickness of the posterior condyle equivalent to the thickness of the distal condyle.  INDUS knee also incorporates the bone sparing principle.  Designed to be a high flexion prosthesis. Indus knee implants

Indus knee prosthesis

Radiological images

 Patient-reported measures of functional outcome are used to evaluate outcomes after TKA.  less expensive,  less time intensive and  reduce the number of patients lost at follow-up because they do not require a clinic visit. Functional outcome measures

 29 patients were done total knee replacement in the year 2015 using Indus prosthesis.  The main indication for knee replacement was severe osteoarthritis(79%).  There were 19 female and 10 males with a mean age of 58.7 years ( range of years)  Follow up of patients done from 3 months to 1 year  Mean knee score was 41 using the oxford knee score. RESULTS

Gender distribution

Indication for surgery

Laterality of surgery

Score months N=29 6 months N=24 12months N= Oxford knee scores

 Total knee replacement (TKR) surgery is one of the most common and successful surgical interventions.  Provides substantial relief from pain and improvement in functional disability in patients with knee arthritis.  Patient-reported outcome measures provides substantial assessment for the outcome. Discussion

 Study demonstrates that the Indus Knee implants enables patients have satisfactory functional outcome after surgery.  Average oxford score at 1 year was 41 which is satisfactory.  Two patients still had some stiffness and 5 other patients reported pain that is relieved by analgesics.  Long term follow up to determine longevity of the implant is recommended. Cont’