Dataset Information

Higher mid-term revision rates of posterior stabilized compared with cruciate retaining total knee arthroplasties: 133,841 cemented arthroplasties for osteoarthritis in the Netherlands in 2007-2016.

ABSTRACT: Background and purpose - The preference for a cruciate retaining (CR) or posterior stabilized (PS) TKA (total knee arthroplasty) system varies greatly between Dutch hospitals, independent of patient characteristics. We examined mid-term revision rates for men and women of different age categories. Patients and methods - We included all 133,841 cemented fixed-bearing primary CR or PS TKAs for osteoarthritis reported in the Dutch Arthroplasty Register (LROI) in 2007-2016. Revision procedures were defined as minor when only insert and/or patella were revised and as major when fixed components (tibia and femur) were revised or removed. 8-year all-cause revision rates of CR and PS TKAs were calculated using competing-risk analyses. Cox-regression analyses were performed, adjusted for age at surgery, sex, ASA -score, and previous operations. Results - PS TKAs were 1.5 (95% CI 1.4-1.6) times more likely to be revised within 8 years of the primary procedure, compared with CR TKAs. When stratified for sex and age category, 8-year revision rate of PS TKAs in men <60 years was 13% (CI 11-15), compared to 7.2% (CI 6.1-8.5) of CR TKAs. Less prominent differences were found in older men and women. For men <60 years differences were found for minor (CR 1.8% (CI 1.4-2.5); PS 3.7% (CI 3.0-4.7)) and major revisions (CR 4.2% (CI 3.3-5.3); PS 7.0% (CI 5.6-8.7)). Interpretation - Patients who received a cemented fixed-bearing primary PS TKA for osteoarthritis are more likely to undergo either a minor or a major revision within 8 years. This is especially prominent for younger men.

SUBMITTER: Spekenbrink-Spooren A

PROVIDER: S-EPMC6300738 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Higher mid-term revision rates of posterior stabilized compared with cruciate retaining total knee arthroplasties: 133,841 cemented arthroplasties for osteoarthritis in the Netherlands in 2007-2016.

Spekenbrink-Spooren Anneke A Van Steenbergen Liza N LN Denissen Geke A W GAW Swierstra Bart A BA Poolman Rudolf W RW Nelissen Rob G H H RGHH

Acta orthopaedica 20181023 6

Background and purpose - The preference for a cruciate retaining (CR) or posterior stabilized (PS) TKA (total knee arthroplasty) system varies greatly between Dutch hospitals, independent of patient characteristics. We examined mid-term revision rates for men and women of different age categories. Patients and methods - We included all 133,841 cemented fixed-bearing primary CR or PS TKAs for osteoarthritis reported in the Dutch Arthroplasty Register (LROI) in 2007-2016. Revision procedures were ...[more]

PMID: 30350747

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Project description:Background/objectiveAccording to previous studies, physiological gait pattern was found in unicompartmental knee arthroplasty (UKA) as compared to total knee arthroplasty (TKA) concerning the gait parameters including gait speed, cadence, and step length. However, little attention had been paid to the detailed kinematic and kinetic differences during gait between TKAs and UKAs. The aim of the present study was to investigate and to clarify the biomechanical differences between posterior stabilized TKAs and fixed bearing UKAs during walking.MethodsA total of 28 patients participated in the present study. Fifteen patients who underwent TKA and thirteen patients who underwent UKA were enrolled. Gait analysis was done at an average of 12.9 months after surgery. The subjects performed level walking at a preferred speed. For each subject, three-dimensional kinematic, kinetic and ground reaction force data were recorded as well as clinical data including range of motion at the knee joint and plain radiographs. Differences of knee kinematics or kinetics were compared between TKAs and UKAs using two-tailed Mann Whitney U-test.ResultsOn physical examination, passive range motion was significantly smaller in TKAs than in UKAs, while femorotibial angle on plain radiographs was not significantly different on plain radiographs. In terms of kinematics, TKAs were more flexed at heel contact and less extended in mid-stance phase compared to UKAs in the sagittal plane, and total excursion of TKAs were also smaller than UKAs. Regarding knee kinetics, TKA patients had significantly less peak tibial internal rotation moment in terminal stance phase. In addition, peak knee adduction moment was significantly larger in UKAs than in TKAs, while peak knee flexion moment was not significantly different.ConclusionPosterior stabilized TKAs exhibited less peak tibial internal rotation moment, which is known as pivot shift avoidance gait, in the present study, compared to fixed bearing UKAs. TKAs had similar gait pattern to anterior cruciate ligament deficient knees, compared to UKAs even if patients with TKAs had no subjective pain during walking.

Project description:AimsThe primary objective of this study was to compare migration of the cemented ATTUNE fixed bearing cruciate retaining tibial component with the cemented Press-Fit Condylar (PFC)-sigma fixed bearing cruciate retaining tibial component. The secondary objectives included comparing clinical and radiological outcomes and Patient Reported Outcome Measures (PROMs).MethodsA single blinded randomized, non-inferiority study was conducted including 74 patients. Radiostereometry examinations were made after weight bearing, but before hospital discharge, and at three, six, 12, and 24 months postoperatively. PROMS were collected preoperatively and at three, six, 12, and 24 months postoperatively. Radiographs for measuring radiolucencies were collected at two weeks and two years postoperatively.ResultsThe overall migration (mean maximum total point motion (MPTM)) at two years was comparable: mean 1.13 mm (95% confidence interval (CI), 0.97 to 1.30) for the ATTUNE and 1.16 mm (95% CI, 0.99 to 1.35) for the PFC-sigma. At two years, the mean backward tilting was -0.43° (95% CI, -0.65 to -0.21) for the ATTUNE and 0.08° (95% CI -0.16 to 0.31), for the PFC-sigma. Overall migration between the first and second postoperative year was negligible for both components. The clinical outcomes and PROMs improved compared with preoperative scores and were not different between groups. Radiolucencies at the implant-cement interface were mainly seen below the medial baseplate: 17% in the ATTUNE and 3% in the PFC-sigma at two weeks, and at two years 42% and 9% respectively (p = 0.001).ConclusionIn the first two postoperative years the initial version of the ATTUNE tibial component was not inferior with respect to overall migration, although it showed relatively more backwards tilting and radiolucent lines at the implant-cement interface than the PFC-sigma. The version of the ATTUNE tibial component examined in this study has subsequently undergone modification by the manufacturer. Level of Evidence: 1 (randomized controlled clinical trial) Cite this article: Bone Joint J 2020;102-B(9):1158-1166.

Dataset Information

Higher mid-term revision rates of posterior stabilized compared with cruciate retaining total knee arthroplasties: 133,841 cemented arthroplasties for osteoarthritis in the Netherlands in 2007-2016.

Publications

Higher mid-term revision rates of posterior stabilized compared with cruciate retaining total knee arthroplasties: 133,841 cemented arthroplasties for osteoarthritis in the Netherlands in 2007-2016.

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