This was a retrospective cohort study of all simultaneous bilateral TKAs performed by a single surgeon in an academic institution between May 2003 and November 2017. All patients received the NexGen LPS-Flex (Zimmer, USA) total knee prosthesis. Inclusion criteria were all bilateral TKAs performed for osteoarthritis (OA) between May 2003 and November 2017 with a minimum of four years’ follow-up. Exclusion criteria were the use of partial knee arthroplasty procedures, staged bilateral procedures, and procedures where both sides were operated on by the same person (for example, both by a trainee or by the surgeon). Institutional Review Board approval was granted prior to commencing this study.
Nexgen lps flex
Manufactured by Zimmer Biomet
Sourced in United States
The NexGen LPS-Flex is a knee implant system designed by Zimmer Biomet. It is a component of the company's NexGen family of knee replacement products. The NexGen LPS-Flex is intended to provide a range of motion and flexibility for patients undergoing total knee arthroplasty.
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Lab products found in correlation
8 protocols using nexgen lps flex
1
Bilateral TKA for Osteoarthritis
2
Standardized Surgical Approach for TKA
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All surgeries were performed by one arthroplasty surgeon in operation rooms with the same laminar airflow. All patients were placed in supine position and underwent general anesthesia combined with peripheral nerve blocks. A thigh tourniquet was applied and inflated to 100 mm Hg above systolic in all patients. Exposure of the surgical site was obtained by either a standard medial parapatellar approach or a mid‐vastus approach21 , 22 , the patella was translated laterally instead of everted, and severe cartilage wear and massive osteophytes were found and removed in all patients intraoperatively. In the PS group, a Zimmer NexGen prosthesis (NexGen LPS Flex, Zimmer, Warsaw) was applied for each patient. In the MP group, a Wright Advance prosthesis was used. Antibiotic prophylaxis was given prior to inflation of the tourniquet and two doses were administered postoperatively. All patients received a tourniquet with postoperative ultrasound, and NSAIDS or opioids for pain relief after TKA if necessary.
3
Retrospective Analysis of Medial OA TKA
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We retrospectively analysed 98 knees in patients with medial osteoarthritis excluding the rheumatoid arthritis patients who underwent TKA using fixed-bearing TKA (NexGen LPS Flex, Zimmer). All patients provided informed consent to participate in this institutional review board-approved study.
4
Standardized Total Knee Arthroplasty Protocol
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All surgeries were performed by a single skilled surgeon (M.C.L.) to minimize operator bias. An anterior midline skin incision and medial parapatellar arthrotomy with resection of both cruciate ligaments were performed. A uniform knee prosthesis bearing (NexGen LPS-Flex, Zimmer, Warsaw, IN) was implanted. After knee prosthesis fixation with cement, the posterior knee was infiltrated with a drug combination of ropivacaine 180 mg (24 mL) and ketorolac 30 mg (1 mL) mixed with normal saline to a total volume of 30 mL. This composite was injected into the posterior capsule (10 mL), quadriceps tendon (5 mL), lateral capsule/synovium (5 mL), and subcutaneous tissue along the midline incision site (10 mL). Intra-articular closed-suction drainage tube with BAROVAC (400 mL, Sewoon Medical, Seoul, Republic of Korea) was inserted in all patients until postoperative day (POD) 2.
5
Caucasian and South Korean Knee Evaluations
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Nine living Caucasian knees (range, 66 to 78 years) and 13 South Korean knees (range, 61 to 74 years) were studied with Institutional Review Board approval15 (link)16 (link)17 (link)18) (link)(Table 1 ). All knees were operated using a fixed bearing posterior-substituting (PS) TKA (Nexgen LPS-Flex; Zimmer, Warsaw, IN, USA) and were evaluated as clinically successful at the time of postoperative follow-up.
6
Comparative Analysis of Knee Arthroplasty Designs
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We enrolled 80 patients who underwent TKA for degenerative arthritis of the knee between October 2013 and March 2014 in this prospective, non-randomized study. The surgery was performed by the same surgeon using the same technique in all patients. The indication for surgery was degenerative knee arthritis. We included only female patients to rule out the influence of gender. Their mean age was 68.4 years. The exclusion criterion was severe bone defect that requires structural bone grafting or metal augmentation. Patients were divided into group I (n=40) and group II (n=40) according to the type of implant used. Group I consisted of patients who received the closed box design (PFC Sigma PS150 RP; DePuy, Warsaw, IN, USA) whereas patients in group II received the open box design (Nexgen LPS-Flex; Zimmer, Warsaw, IN, USA).
There was no statistically significant difference between the groups in terms of baseline age, body mass index, bone mineral density, limitation in range of motion, and coronal plane deformity (Table 1 ).
There was no statistically significant difference between the groups in terms of baseline age, body mass index, bone mineral density, limitation in range of motion, and coronal plane deformity (
7
Navigated vs. Conventional Posterior Stabilized TKA
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All patients received a cemented posterior stabilized NexGen LPS Flex (Zimmer, Warsaw, Indiana, USA).
Participants randomised to the conventional group received a TKA implanted using standard instrumentation whilst those randomised to the navigated group had surgery using the iNav EM navigation system (Medtronic, Minneapolis, MN, USA) . The iNav EM system is imageless and uses small reference frames attached to the femur and tibia which are readily incorporated in the primary incision.
There is then a process of joint registration which maps the surface anatomy of the joint. All surgery including joint surface registration was carried out by, or under the direct supervision of, one of two knee arthroplasty surgeons. Alignment targets were similar in both groups with a neutral hip-knee-ankle alignment (HKAA) and the aim to implant both femur and tibial components perpendicular to this in the coronal plane. The post-op HKAA for both groups were; Navigated TKA = 179. Ligament balancing was carried using clinical assessment during the surgical procedure in both groups.
In the navigated group additional information was provided by the system with real time feedback of the gap in mm between the femoral and tibial component and of the overall HKAA during varus and valgus stress.
Participants randomised to the conventional group received a TKA implanted using standard instrumentation whilst those randomised to the navigated group had surgery using the iNav EM navigation system (Medtronic, Minneapolis, MN, USA) . The iNav EM system is imageless and uses small reference frames attached to the femur and tibia which are readily incorporated in the primary incision.
There is then a process of joint registration which maps the surface anatomy of the joint. All surgery including joint surface registration was carried out by, or under the direct supervision of, one of two knee arthroplasty surgeons. Alignment targets were similar in both groups with a neutral hip-knee-ankle alignment (HKAA) and the aim to implant both femur and tibial components perpendicular to this in the coronal plane. The post-op HKAA for both groups were; Navigated TKA = 179. Ligament balancing was carried using clinical assessment during the surgical procedure in both groups.
In the navigated group additional information was provided by the system with real time feedback of the gap in mm between the femoral and tibial component and of the overall HKAA during varus and valgus stress.
8
Knee Arthroplasty Rehabilitation Protocol
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Individuals who were admitted to the Joint Replacement Centre of the Buddhist Hospital in Hong Kong for TKA from February 2013 to January 2014 and referred to out-patient physiotherapy were recruited. The implants used were cemented cruciate-substituting prostheses (Zimmer model: NexGen LPS-Flex, UK). The inclusion criteria consisted of individuals aged 50-85 years with diagnosed knee osteoarthritis with a first occurrence of TKA; as well as being able to follow verbal instructions and provide informed consent. Exclusion criteria were: TKA due to rheumatoid arthritis or traumatic injury; previous history of surgery in the lower limbs; and known medical diagnoses that affect balance (e.g., stroke). This study was approved by the Human Research Ethics Subcommittee in accordance with the Declaration of Helsinki.
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