A Retrospective Comparison of a Medial Pivot and Posterior-Stabilized Total Knee Arthroplasty With Respect to Patient-Reported and Radiographic Outcomes

Samy, David A.; Wolfstadt, Jesse; Vaidee, Iman; Backstein, David

doi:10.1016/j.arth.2017.11.049

Cited by 79 publications

(96 citation statements)

References 38 publications

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“…16 Samy et al compared 76 MP articulations with 88 PS articulations in a retrospective review and found that although range of motion was not statistically different between the two groups, the MP group did statistically and significantly better in terms of the Forgotten Joint Score compared with the PS group, especially when looking at deep knee flexion and stability of the prosthesis. 17 A lateral pivot design has also been evaluated, which uses a higher level of lateral congruence to provide AP translational control and axial rotation and yet allows femoral rollback in deep flexion through asymmetry of the femoral component. This has been shown by Harman et al in a mixed cohort of PCL-retaining or resected knee arthroplasties to provide good-to-excellent outcomes in 84% of patients at 8 to 10 years of follow-up.…”

Section: Clinical Studiesmentioning

confidence: 99%

A Cam–Post Mechanism Is No Longer Necessary in Modern Primary Total Knee Arthroplasty

Meneghini

Stefl

Hodge³

et al. 2019

J Knee Surg

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Conclusive evidence supporting a clinical difference between posterior-stabilized (PS) and cruciate-retaining (CR) designs in total knee arthroplasty (TKA) does not currently exist, despite both designs being used for decades. Proponents of PS designs that employ a cam-and-post mechanism cite in vivo fluoroscopic data that demonstrate improved posterior rollback; however, optimal rollback has never been correlated to superior clinical outcomes. Recently, anterior-lipped and more conforming CR bearings, such as ultracongruent, medial pivot, and dual-pivot designs, have been used to substitute for the posterior cruciate ligament and obviate the need for the cam–post mechanism of a traditional PS design. Advantages of avoiding a PS TKA include eliminating the risk of box cut induced femoral condylar fracture, improving operative efficiency by removing procedural steps, removing the articulation that is a source of wear, postdeformation, breakage, or dislocation, and eliminating patellar clunk. Health care reform efforts mandate cost reduction, and procedural efficiencies and minimizing inventory through the removal of unnecessary bearing options foster that initiative.

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Section: Clinical Studiesmentioning

confidence: 99%

A Cam–Post Mechanism Is No Longer Necessary in Modern Primary Total Knee Arthroplasty

Meneghini

Stefl

Hodge³

et al. 2019

J Knee Surg

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show abstract

“…Based on these theoretical advantages, the design features of the medial pivot prosthesis may decrease the risk of patellofemoral joint problems [11,12]. Several studies have reported clinical satisfaction and survival analysis of TKA for this prosthesis [13][14][15][16], however, the comparison of clinical and radiographic results of this prosthetic patellofemoral joint with another prosthesis was rare [11].…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Early Patellofemoral Function of Unilateral TKA with Medial Pivot Prostheses is Superior than with Conventional Posterior-Stabilized Prostheses

Wang

Zhang

Ding

et al. 2019

Preprint

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PurposeThe purpose of this study was to provide a systematic evaluation of the patellofemoral joint design of Medial Pivot Prosthesis, which incorporates a variety of “Patella-friendly” design features, by comparing clinical and radiographic results with another prosthesis. MethodsEarly clinical and radiographic results of patients who underwent unilateral TKA with Medial Pivot Prosthesis (The study group, including 126 cases) and conventional Posterior-Stabilized Prosthesis (The control group) were retrospectively compared. Postoperative complications, including anterior knee pain, maltracking, patellar clunk or crepitus (PCC), were evaluated.ResultsThe postoperative Kujala score and its improvement from baseline in the study group (Group A) were significantly higher than those in the control group(Group B). The range of motion (ROM) in group A, including the improvement in ROM, was significantly inferior to group B. In the 90-degree Merchant view, the patellar tilt in group A was smaller than that in group B. Two cases of PCC and 3 cases of anterior knee pain were noted in group A, and 9 cases and 6 cases, respectively, were observed in group B. The incidence of PCC was significantly lower in group A. There were no significant between-group differences in the patella tilt angle at 30 or 60° or in the postoperative patellar translation at 30, 60 or 90°. No between-group difference in posterior condyles angle (PCA) was observed. The KSS scores and WOMAC scores between the two groups were similar.ConclusionThe medial pivot prosthesis could achieve satisfactory outcomes with superior patellofemoral performance attributed to its “patella-friendly” design characteristics compared to the conventional posterior-stabilized prosthesis.

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“…We demonstrated the MS TKA to have significantly superior PROMs on all validated scales (FJS, KOOS, Western Ontario and McMaster Universities Osteoarthritis Index, and Oxford Knee Score), with the greatest difference on the FJS. Samy et al [8] found similar results with the FJS, with the MS TKA favored over a PS TKA. This was particularly true when patients were asked if they were aware of their knee when standing from a low-sitting position; an activity that requires mid-flexion stability [8].…”

Section: Discussionmentioning

confidence: 60%

“…Samy et al [8] found similar results with the FJS, with the MS TKA favored over a PS TKA. This was particularly true when patients were asked if they were aware of their knee when standing from a low-sitting position; an activity that requires mid-flexion stability [8]. No significant difference was seen between the MS TKA and the non-MS TKA groups according to VAS patient satisfaction, likely due to the well-recognized ceiling effect of VAS [17].…”

Section: Discussionmentioning

confidence: 60%

Sagittal Stability and Implant Design Affect Patient Reported Outcomes After Total Knee Arthroplasty

Jones

Jacobs

Shumborski

et al. 2020

The Journal of Arthroplasty

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A Retrospective Comparison of a Medial Pivot and Posterior-Stabilized Total Knee Arthroplasty With Respect to Patient-Reported and Radiographic Outcomes

Cited by 79 publications

References 38 publications

A Cam–Post Mechanism Is No Longer Necessary in Modern Primary Total Knee Arthroplasty

A Cam–Post Mechanism Is No Longer Necessary in Modern Primary Total Knee Arthroplasty

WITHDRAWN: Early Patellofemoral Function of Unilateral TKA with Medial Pivot Prostheses is Superior than with Conventional Posterior-Stabilized Prostheses

Sagittal Stability and Implant Design Affect Patient Reported Outcomes After Total Knee Arthroplasty

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