Dataset Information

Clinical Results of Oxidized Zirconium Femoral Component in TKA. A Review of Long-Term Survival: Review Article.

ABSTRACT:

Background

Oxidized zirconium (OxZr) femoral component for total knee arthroplasty (TKA) have been introduced in an attempt to reduce polyethylene wear and secondary osteolysis and improve longevity of implants.

Questions/purposes

We reviewed clinical studies in literature evaluating OxZr femoral component for TKA. The aim of this review was to evaluate the clinical outcome and survival rate of TKA with an OxZr femoral component.

Methods

A review of the existing literature was undertaken to collect data on the OxZr femoral component in order to provide a better understanding of its performance. Of 34 studies published in the literature, 8 met the eligibility criteria and were included in the final analysis.

Results

Findings indicated that the mean Knee Society knee score improved in all series from preoperative to postoperative evaluation. The postoperative Knee Society knee score reported range from 84 to 95 and mean postoperative Knee Society functional score range from 74 to 90. The revision rate with this implant is low with up to 12.6 years of follow-up, with three revisions in total. The survival rate ranged from 100-98.7% at 5-7 years to 97.8% at 10 years.

Conclusions

Excellent clinical outcome and high survival rate has been demonstrated for OxZr femoral component in TKA. No adverse reaction has been described for this new material.

SUBMITTER: Civinini R

PROVIDER: S-EPMC5264569 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Publications

Clinical Results of Oxidized Zirconium Femoral Component in TKA. A Review of Long-Term Survival: Review Article.

Civinini Roberto R Matassi Fabrizio F Carulli Christian C Sirleo Luigi L Lepri Andrea Cozzi AC Innocenti Massimo M

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20160713 1

<h4>Background</h4>Oxidized zirconium (OxZr) femoral component for total knee arthroplasty (TKA) have been introduced in an attempt to reduce polyethylene wear and secondary osteolysis and improve longevity of implants.<h4>Questions/purposes</h4>We reviewed clinical studies in literature evaluating OxZr femoral component for TKA. The aim of this review was to evaluate the clinical outcome and survival rate of TKA with an OxZr femoral component.<h4>Methods</h4>A review of the existing literature ...[more]

PMID: 28167871

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Project description:BackgroundWhen using the gap-balancing technique for TKA, excessive medial release and varus proximal tibial resection can be associated with internal rotation of the femoral component. Previous studies have evaluated the causes of femoral component rotational alignment with a separate factor analysis using unadjusted statistical methods, which might result in treatment effects being attributed to confounding variables.Questions/purposes(1) What pre- and intraoperative factors are associated with internal rotation of the femoral component in TKA using the gap balancing technique? (2) To what degree does femoral component rotation as defined by the navigation system differ from rotation as measured by postoperative CT?MethodsThree hundred seventy-seven knees that underwent computer-assisted primary TKA attributable to degenerative osteoarthritis with varus or mild valgus alignment in which medial soft tissue release was performed, and those with preoperative radiographs including preoperative CT between October 2007 and June 2014 were included in the study. To achieve a balanced mediolateral gap, the structures released during each medial release step were as follows: Step 1, deep medial collateral ligament (MCL); Step 2, superficial MCL (proximal, above the pes anserine tendon) and semimembranosus tendon; and Step 3, the superficial MCL (distal, below the pes anserine tendon). Knees with internal rotation of the femoral component, which was directed by navigation, to achieve a rectangular mediolateral flexion gap were considered cases, and knees without internally rotated femoral components were considered controls. Univariable analysis of the variables (age, sex, BMI, operated side, preoperative hip-knee-ankle angle, preoperative medial proximal tibial angle, preoperative rotation degree of the clinical transepicondylar axis [TEA] relative to the posterior condylar axis [PCA], coronal angle of resected tibia, resection of the posterior cruciate ligament, type of prosthesis, and extent of medial release) of cases and controls was performed, followed by a multivariable logistic regression analysis on those factors where p equals 0.15 or less. For an evaluation of navigation error, 88 knees that underwent postoperative CT were analyzed. Postoperative CT scans were obtained for patients with unexplained pain or stiffness after the operations. Using the paired t-test and Pearson's correlation analysis, the postoperative TEA-PCA measured with postoperative CT was compared with theoretical TEA-PCA, which was calculated with preoperative TEA-PCA and actual femoral component rotation checked by the navigation system.ResultsAfter controlling for a relevant confounding variable such as postoperative hip-knee-ankle angle, we found that the extent of medial release (Step 1 as reference; Step 2: odds ratio [OR], 5.7, [95% CI, 2.2-15]; Step 3: OR, 22, [95% CI, 7.8-62], p < 0.001) was the only factor we identified that was associated with internal rotation of the femoral component. With the numbers available, we found no difference between the mean theoretical postoperative TEA-PCA and the postoperative TEA-PCA measured using postoperative CT (4.8° ± 2.7º versus 5.0° ± 2.3º; mean difference, 0.2° ± 1.5º; p = 0.160).ConclusionsExtent of medial release was the only factor we identified that was associated with internal rotation of the femoral component in gap-balancing TKA. To avoid internal rotation of the femoral component, we recommend a carefully subdivided medial-releasing technique, especially for the superficial MCL because once the superficial MCL has been completely released it cannot easily be restored.Level of evidenceLevel III, therapeutic study.

Dataset Information

Clinical Results of Oxidized Zirconium Femoral Component in TKA. A Review of Long-Term Survival: Review Article.

Background

Questions/purposes

Methods

Results

Conclusions

Publications

Clinical Results of Oxidized Zirconium Femoral Component in TKA. A Review of Long-Term Survival: Review Article.

Similar Datasets

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