Dataset Information

Comparison of Revision Rates of Non-modular Constrained Versus Posterior Stabilized Total Knee Arthroplasty: a Propensity Score Matched Cohort Study.

ABSTRACT:

Background

Attaining stability during total knee arthroplasty (TKA) is essential for a successful outcome. Although traditional constrained total knee prostheses have generally been used in conjunction with intramedullary stems, some devices have been widely used without the use of stems, referred to as non-modular constrained condylar total knee arthroplasty (NMCCK).

Questions/purposes

The aim of this study was to compare revisions rates after total knee replacement with a non-modular constrained condylar total knee (NMCCK) compared to a posterior-stabilized (PS) design.

Methods

Between 2007 and 2012, primary PS total knees were compared with NMCCK implants from the same manufacturer. Propensity score matching was performed, and implant survivorship was examined using a Cox proportional hazards model. The cohort consisted of 817 PS knees and 817 NMCCKs matched for patient demographics, surgeon volume, and pre-operative diagnosis.

Results

All cause revisions occurred in 11 of 817 (1.35%) in the PS group compared to 28 of 817 (3.43%) in the NMCCK group (p?=?0.0168). Excluding revisions for infection and fracture, 8 of 817 (0.98%) PS knees required revision for mechanical failure compared to 18 of 817 (2.20%) NMCCK knees (p?=?0.0193).

Conclusions

While revisions rates in both cohorts were low, there was a significantly higher revision rate with NMCCKs. Given that cases requiring the use of NMCCK implants are likely more complex than those in which PS implants are used, our findings support the judicious use of NMCCK prostheses.

SUBMITTER: Moussa ME

PROVIDER: S-EPMC5264581 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Comparison of Revision Rates of Non-modular Constrained Versus Posterior Stabilized Total Knee Arthroplasty: a Propensity Score Matched Cohort Study.

Moussa Mohamed E ME Lee Yuo-Yu YY Westrich Geoffrey H GH Mehta Nabil N Lyman Stephen S Marx Robert G RG

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20161117 1

<h4>Background</h4>Attaining stability during total knee arthroplasty (TKA) is essential for a successful outcome. Although traditional constrained total knee prostheses have generally been used in conjunction with intramedullary stems, some devices have been widely used without the use of stems, referred to as non-modular constrained condylar total knee arthroplasty (NMCCK).<h4>Questions/purposes</h4>The aim of this study was to compare revisions rates after total knee replacement with a non-mo ...[more]

PMID: 28167876

Similar Datasets

Project description:There is debate in the literature whether rotating hinge knee (RHK) or constrained condylar knee (CCK) prostheses lead to better clinical outcomes and survival rates in patients undergoing revision total knee arthroplasty (RTKA). The purpose of this meta-analysis is to compare the survivorship and clinical outcomes of RHK and CCK prostheses. In this meta-analysis, we reviewed studies that evaluated pain and function scores, range of motion (ROM), complications, and survival rates in patients treated with RHK or CCK with short-term (<5 years) or midterm (5-10 years) follow-up. The survivorship was considered as the time to additional surgical intervention such as removal or revision of the components. A total of 12 studies (one randomized study and 11 non-randomized studies) met the inclusion criteria and were analyzed in detail. The proportion of the knees in which short-term (<5 years) survival rates (RHK, 83/95; CCK, 111/148; odds ratio [OR] 0.52; 95% CI, 0.24-1.11; P = 0.09) and midterm (5-10 years) survival rates (RHK, 104/128; CCK, 196/234; OR 1.05; 95% CI, 0.56-1.97; P = 0.88) were evaluated did not differ significantly between RHK and CCK prostheses. In addition, there were no significant differences in ROM (95% CI: -0.40 to 9.93; P = 0.07) and complication rates (95% CI: 0.66 to 2.49; P = 0.46). In contrast, CCK groups reported significantly better pain score (95% CI: 0.50 to 2.73; P = 0.005) and function score (95% CI: 0.01 to 2.00; P = 0.05) than RHK groups. This meta-analysis revealed that 87.4% of RHK and 75.0% of CCK prostheses survive at short-term (<5 years), while 81.3% of RHK and 83.8% of CCK prostheses survive at midterm (5-10 years). The differences in standardized mean pain and function scores we detected were likely to be imperceptible to patients and almost certainly below the minimum clinically important level, despite a significant difference in both groups. Based on the findings of the current meta-analysis, RHK prostheses continue to be an option in complex RTKA with reasonable midterm survivorship.

Dataset Information

Comparison of Revision Rates of Non-modular Constrained Versus Posterior Stabilized Total Knee Arthroplasty: a Propensity Score Matched Cohort Study.

Background

Questions/purposes

Methods

Results

Conclusions

Publications

Comparison of Revision Rates of Non-modular Constrained Versus Posterior Stabilized Total Knee Arthroplasty: a Propensity Score Matched Cohort Study.

Similar Datasets

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