Does a new implant design with more physiological kinematics provide better results after knee arthroplasty?

Sanz-Ruíz, Pablo; Carbó-Laso, Esther; Alonso-Polo, B; Matas-Diez, José Antonio; Vaquero-Martín, Javier

doi:10.1016/j.knee.2016.02.017

Cited by 19 publications

(13 citation statements)

References 33 publications

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“…The goal is to provide a “guided motion” which should lead to kinematics similar to that of a normal knee [ 16 – 19 ]. This guided motion has been reported in different studies comparing the JOURNEY™ I BCS prosthesis to other TKA systems and normal knees [ 20 – 25 ]. In vivo fluoroscopic studies demonstrated that nearly normal kinematic motions can be attained with the JOURNEY™ BCS TKS [ 21 , 22 , 24 , 26 – 30 ].…”

Section: Introductionsupporting

confidence: 62%

Second-generation bi-cruciate stabilized total knee system has a lower reoperation and revision rate than its predecessor

Christen¹,

Kopjar

2018

Arch Orthop Trauma Surg

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IntroductionTotal knee arthroplasty (TKA) can provide pain relief and good long-term results. However, nearly 30% of post-surgical patients are unsatisfied due to persistent pain and functional deficits. A second-generation bi-cruciate stabilized TKA device has a post-cam mechanism with an asymmetric femoral component, a polyethylene insert, and a medially concave and laterally convex shape. The device is designed to provide guided motion, and thus improve knee kinematics by more closely approximating a normal knee. The aim of this study was to evaluate early complication and revision rates of the second-generation device and to compare its clinical performance to the first-generation device.Materials and methodsIn this retrospective, longitudinal, non-concurrent cohort study, 140 TKAs were performed using the second-generation device on 131 patients from 2012 to 2016, and 155 TKAs were performed using the first-generation device on 138 patients from 2009 to 2012. Primary outcomes were occurrence of revisions and reoperations.ResultsThere were 31 reoperations [3.21 per 100 observed component years (OCY)] in 22 (2.28 per 100 OCY) TKAs in the first-generation device cohort compared to five reoperations (1.92 per 100 OCY) in four TKAs (1.54 per 100 OCY) in the second-generation device cohort. The adjusted hazard ratio (HR) was 3.50 (P = 0.0254). There were 21 revisions (2.17 per 100 OCY) in 16 (1.66 per 100 OCY) TKAs in the first-generation device cohort, compared to only three revisions (1.15 per 100 OCY) in two TKAs (0.77 per 100 OCY) in the second-generation device cohort. The adjusted HR was 4.16 (P = 0.0693).ConclusionThe improved design of the second-generation device appears to be associated with a lower risk of reoperation and revision compared to that of the first-generation device.Level of evidenceIII.

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Section: Introductionsupporting

confidence: 62%

Second-generation bi-cruciate stabilized total knee system has a lower reoperation and revision rate than its predecessor

Christen¹,

Kopjar

2018

Arch Orthop Trauma Surg

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“…Despite this complication, the overall survivorship of the first-generation prosthesis was 98%. Sanz-Ruiz et al [15] reported a similar rate of ITBS at 6.6%. In our study, using the second-generation device, the rate of ITBS was 0.96%, suggesting that this complication is less common with the second-generation device.…”

Section: Discussionmentioning

confidence: 84%

Short-term safety and effectiveness of a second-generation motion-guided total knee system

Harris¹,

Luo

Lang

et al. 2018

Arthroplasty Today

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BackgroundModern knee prostheses are designed to more closely replicate normal knee kinematics. The JOURNEY II Bi-Cruciate Stabilized Total Knee System (Smith & Nephew Inc., Memphis, TN) is a second-generation motion-guided knee system that demonstrates axial rotation patterns during flexion, which resemble those of the normal knee. The aim of this study was to assess the short-term safety and effectiveness of this system in standard clinical practice.MethodsA total of 186 subjects (209 primary total knee arthroplasties [TKAs]) were enrolled at 12 U.S. sites. Subjects were operated on between December 2011 and October 2013 and followed for 24 months. Radiographic, clinical, and patient-reported outcome data were collected at 6-, 12-, and 24-month postoperatively.ResultsAt 24-month follow-up, the average objective Knee Society Score was 96.20 (standard deviation [SD] = 6.63), the average satisfaction score was 35.22 (SD = 6.63), the average expectation score was 10.91 (SD = 3.16), and the average functional activities score was 81.49 (SD = 14.65). On a 0-10 scale, pain level for walking was 0.79 (SD = 1.51) and 1.50 (SD = 1.97) for climbing stairs or inclines. The cumulative incidence of reoperation at 2-year follow-up was 1.48% (95% confidence interval [CI] 0.48%-4.52%). Ten TKAs in 7 patients were treated with closed manipulations for stiffness. Iliotibial band syndrome was reported in 2 TKAs. Two deep infections occurred, 1 requiring reoperation. No dislocations occurred in the study cohort.ConclusionsIn short-term follow-up, the JOURNEY II Bi-Cruciate Stabilized Guided Motion Total Knee System appears to be a safe and effective device for TKA.

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“…Achieving good results after total knee replacement depends on many factors, namely patient selection, implant design, surgical technique and post-operative care (12). However, more than 20% of patients can still have some dissatisfaction after the procedure (13,14).…”

Section: Discussionmentioning

confidence: 99%

A new educational method before total knee arthroplasty to be applied in developing countries: a randomized controlled trial

Andrade¹,

Silva²,

Campos³

et al. 2020

Preprint

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Background In developing countries, the illiteracy index is high in public hospitals. We describe a method in which patients are instructed before total knee arthroplasty (TKA) in a differentiated way without the necessity of reading any self-orientation. Methods To improve patient education before TKA we developed a multidisciplinary method in which an orthopedic surgeon, a nurse and a physiotherapist give the patients a differentiated orientation with specific lectures regarding the pre, intra and post-operative issues in a prospective case-control study of 79 consecutive patients undergoing primary TKA. Twenty-nine patients received the standard verbal education (control group) and 38 patients received the differentiated education (intervention group). The patients were evaluated during at least six months. Results After a 6-month follow-up period, SF-36 and WOMAC forms, VAS and range of motion improved significantly in both groups. ROM was better in the intervention group (mean and SD − 106.9 ± 5.7 versus 92.5 ± 12.1 degrees, p = 0.02). Moreover, walk ability (more than 400 meters) was improved in the intervention group compared with control group (97.4% versus 72.4%, p = 0.003). In the intervention and control groups, respectively, 10.5% and 31% of patients reported the need of some walking device (p = 0.03). Conclusions A differentiated educational program with a multidisciplinary team had a positive impact on functional outcomes, improving ROM and walk ability of patients undergoing TKA in a short-term evaluation.

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Does a new implant design with more physiological kinematics provide better results after knee arthroplasty?

Cited by 19 publications

References 33 publications

Second-generation bi-cruciate stabilized total knee system has a lower reoperation and revision rate than its predecessor

Second-generation bi-cruciate stabilized total knee system has a lower reoperation and revision rate than its predecessor

Short-term safety and effectiveness of a second-generation motion-guided total knee system

A new educational method before total knee arthroplasty to be applied in developing countries: a randomized controlled trial

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