Fixation and clinical outcome of uncemented peri-apatite-coated<i>versus</i>cemented total knee arthroplasty

Hamersveld, Koen T. van; Mheen, P.J. Marang-van de; Tsonaka, Roula; Valstar, Edward R.; Toksvig‐Larsen, Sören

doi:10.1302/0301-620x.99b11.bjj-2016-1347.r3

Cited by 51 publications

(24 citation statements)

References 30 publications

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“…Van Hamersveld et al [13] reported in 2018 in a 6-year follow-up RSA study MTPM of 0.9-1.22 mm in 46 cemented tibial components (posterior stabilized TKAs). In 2017 van Hamersveld et al [14] also reported 5-year MTPM results of 0.97 mm of an uncemented peri-apatite coated tibial tray (Triathlon Ò ) and Molt et al [15] found a mean MTPM after 5 years of 0.66-1.1 mm for cemented tibial components, thus leaving our results with 5-year MTPM of 1.8 and 1.4 mm for respectively VR and VP in the upper end of MTPM for both implants.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of different coatings of the tibial tray in uncemented total knee arthroplasty. A randomized controlled trial with 5 years follow-up with RSA and DEXA

et al. 2021

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Background: Regenerex Ò is a porous titanium construct with a 3D interconnecting pore structure and biomechanical characteristics close to that of normal trabecular bone. This study aimed to compare the Regenerex (VR) to the non-interconnecting pore structure Porous Plasma Spray (VP) on tibial implants for total knee arthroplasty (TKA) at 5 years. Methods: We enrolled and randomized 61 patients (mean age = 63(49-71) years, Female/ Male = 35/26) who were planned for an uncemented Vanguard TKA (Biomet, Warsaw, Indiana, USA) to receive either a VR or a VP coated tibial component (31/29). We performed radiostereometric analysis (RSA) and Dual Energy X-ray Absorptiometry (DEXA) postoperatively, and at three, six, 12, 24 and 60 months with measurements of migration. In total 55 patients attended the 5-year follow-up. Results: One patient died and four were reoperated during the 60-months period; none due to aseptic loosening. All reoperations were in the VR-group. The mean (range) 60-months MTPM was 1.4 mm (0.5-3.7) for the VP-group and 1.8 mm (0.4-4.9) for the VR-group (p = 0.8). The 24 to 60-months mean (range) MTPM was À0.3 mm (À5 to 1.24) in the VP-group and 0.2 mm (À0.4 to 3.5) in the VR-group (p = 0.8). Conclusion:We did not find any statistically significant differences between the VP-and VR-group and both groups show recognizable migration. We will continue to follow the groups for years to come.

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Section: Discussionmentioning

confidence: 99%

Evaluation of different coatings of the tibial tray in uncemented total knee arthroplasty. A randomized controlled trial with 5 years follow-up with RSA and DEXA

et al. 2021

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“…This finding could have been due to early loosening that was not seen radiographically. Radiostereometric analysis (RSA) studies 38,39 have shown significantly higher migration of cementless compared with cemented TKRs. Pijls et al performed a systematic review of RSA studies of TKR migration and concluded that early migration was associated with aseptic loosening 40 .…”

Section: Discussionmentioning

confidence: 99%

A Matched Comparison of the Long-Term Outcomes of Cemented and Cementless Total Knee Replacements

Mohammad

Judge

Murray

2021

Journal of Bone and Joint Surgery

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Background: Total knee replacement (TKR) can be implanted with or without the use of cement. It is currently unknown how cemented and cementless TKRs compare overall and in different age groups of the population in the long term. Methods:The National Joint Registry collects information on knee replacements inserted in England, Wales, Northern Ireland and Isle of Man and was linked for multiple confounders to the National Health Service Hospital Episode Statistics database. Using propensity matched scoring techniques 44,954 cemented and cementless TKRs were compared. Regression models were used to compare the outcomes revision, two stage revision, reoperation and mortality both overall and in different age strata. Results:The 10 year implant survival (revision endpoint) for cemented and cementless TKRs were 96.0% and 95.5% (Hazard Ratio (HR) 1.14, p=0.01). The 10 reoperation endpoint was 82.7% and 81.4% respectively (HR 1.08, p=0.001). The rates of pain were higher in cementless TKRs (0.5% vs 0.7%, p=0.002) but the rates of infection were lower (0.7% vs 0.5%, p=0.003). No significant interactions with age existed for outcomes of; revision (p=0.24), reoperation (p=0.30) or mortality (p=0.58). Conclusions:We found that matched cemented and cementless TKRs both have 10 year implant survivals over 95%. Cementless TKRs had a higher absolute difference in revision rates (0.5%) and reoperation rates (1.3%). The rates of revision for infection were lower in the cementless group, although rates of revision for pain were higher. Age did not significantly affect the relative performances.

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“…T he present study was a secondary analysis of all randomized controlled trials (RCTs) involving RSA for the analysis of primary TKAs that were performed in the last 2 decades at 2 centers (Hässleholm, Sweden; Leiden, the Netherlands). Ten published RSA studies including 636 patients undergoing TKA from 2002 to 2016 were pooled (Table I) [12][13][14][15][16][17][18][19][20][21] . Seven studies were conducted in Hässleholm (432 TKAs) [14][15][16][17][18][19][20] and 3 in Leiden (204 TKAs) 12,13,21 .…”

Section: Materials and Methods Designmentioning

confidence: 99%

The Influence of Postoperative Coronal Alignment on Tibial Migration After Total Knee Arthroplasty in Preoperative Varus and Valgus Knees

Hasan

Kaptein

Nelissen

et al. 2021

Journal of Bone and Joint Surgery

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Background: Orthopaedic surgeons aim for mechanical alignment when performing total knee arthroplasty (TKA) as malalignment is associated with loosening. Loosening may be predicted by migration as measured with radiostereometric analysis (RSA), but previous RSA studies on postoperative alignment have shown contradictory results and have been limited to cemented implants and small numbers of patients. Therefore, we performed a secondary analysis of 10 previously published randomized controlled trials (RCTs) to compare migration between postoperative in-range and out-of-range cemented and uncemented TKA implants among patients with a preoperative varus or valgus knee.Methods: All RCTs involving the use of RSA that had been conducted at 2 centers were included. Alignment was classified, with use of the hip-knee-ankle angle (HKA), as in-range (0°± 3°) or out-of-range (<23°or >3°). The fixation methods included cemented, uncemented-coated, and uncemented-uncoated. Migration was measured at 3, 12, and 24 months. A linear mixed model was used, with adjustment for fixation method and clustering of patients within centers.Results: Of 476 TKA implants that had been out-of-range preoperatively, 290 were in-range postoperatively and 186 were out-of-range in either varus (n = 143) or valgus (n = 43) postoperatively. The mean migration at 3, 12, and 24 months was 0.73 mm (95% confidence interval [CI], 0.66 to 0.79 mm), 0.92 mm (95% CI, 0.85 to 1.00 mm), and 0.97 mm (95% CI, 0.90 to 1.05 mm), respectively, for the in-range group and 0.80 mm (95% CI, 0.72 to 0.87 mm), 0.98 (95% CI, 0.90 to 1.07 mm), and 1.04 mm (95% CI, 0.95 to 1.13 mm), respectively, for the out-of-range group (p = 0.07). The fixation method significantly influenced migration, with uncemented-uncoated implants migrating more than cemented and uncemented-coated implants (p < 0.001).Conclusions: Postoperative alignment did not influence migration of TKAs in the first 2 postoperative years in patients with preoperative varus or valgus alignment of the knee. However, the fixation method significantly influenced migration, with uncemented-uncoated implants showing the greatest migration.

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Fixation and clinical outcome of uncemented peri-apatite-coatedversuscemented total knee arthroplasty

Cited by 51 publications

References 30 publications

Evaluation of different coatings of the tibial tray in uncemented total knee arthroplasty. A randomized controlled trial with 5 years follow-up with RSA and DEXA

Evaluation of different coatings of the tibial tray in uncemented total knee arthroplasty. A randomized controlled trial with 5 years follow-up with RSA and DEXA

A Matched Comparison of the Long-Term Outcomes of Cemented and Cementless Total Knee Replacements

The Influence of Postoperative Coronal Alignment on Tibial Migration After Total Knee Arthroplasty in Preoperative Varus and Valgus Knees

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