No difference in patient preference for medial pivot versus posterior-stabilized design in staged bilateral total knee arthroplasty: a prospective study

Abstract

Purpose Medial pivot (MP) TKA has been shown to mimic normal knee kinematics with long-term survivorship comparable to most contemporary TKA. However, there are inadequate evidences to suggest its superiority in terms of patient preference and satisfaction. The aim of this study is to compare the MP with posterior-stabilized (PS) TKA in terms of patient preference and satisfaction. Methods 46 patients with staged bilateral TKA were recruited. TKA with MP or PS design was performed at interval of 6-12 months. Patient preference, patient satisfaction score (0-100), Forgotten Joint Score (FJS), range of motion (ROM), Pain Score, Knee Society Score (KSS), Knee Function Score (KFS) and WOMAC Score were compared at up to 12 months. Results The mean age was 70 and 69.6% were female. There was no diference in all preoperative parameters, operative time and length of stay between two knees. No diference was found in in range of motion and all outcome scores at 6 months and 12 months. Satisfaction score was similar for the two designs (82 vs 85, p = n.s.) at 1 year after the second TKA. Proportion of patients with preference on one design over another was not signiicantly diferent (28.9 vs 35.6%, p = n.s.). Conclusions There is no evidence to support the superiority of MP TKA over PS TKA in terms of preference and satisfaction. The choice between MP TKA versus PS TKA maybe more a surgeon's preference than a patient's preference based on current evidence.

Clinical radiographic outcomes and survivorship of medial pivot design total knee arthroplasty: a systematic review of the literature

“…Details are reported within Table 1. Two studies were level of evidence I [10,19], 8 studies level II [9,[20][21][22][23][24][25][26], and 24 level IV [8,11,.…”

“…Twenty-two studies were rated as very low quality [8, 11, 27, 28, 30-45, 47, 48], 6 low quality [22-24, 26, 29, 46], 4 moderate [9,10,21,25], and 2 high quality [19,20] (Table 1). The risk of bias was considered high in 1 research [11], serious in 19 [8, 27, 30-36, 38-45, 47, 48], and moderate in 4 [28,29,37,46]; 9 [9,[19][20][21][22][23][24][25][26] had some concerns and one RCT [10] had low risk of bias.…”

Evaluating the “Patella-Friendly” Concept in Total Knee Arthroplasty: A Minimum 15-Year Follow-Up Outcome Study Comparing Constant Radius, Multiradius Cruciate-Retaining, and Nonanatomical Cruciate-Retaining Implants

“…In a prospective bilateral randomized trial using a single-radius PS, TKA patients were unaware of any differences due to patellar resurfacing as assessed by postoperative anterior knee pain, Forgotten Joint Score, and an objective Feller patellofemoral score at 11-year follow-up [21]. In a staged bilateral TKA trial comparing a medial pivot knee to a PS design, no differences were found using satisfaction and both objective and subjective evaluation scales (but not a separate patellofemoral score) at 1-year follow-up [51]. In an RCT comparing a medial pivot to PS design, superior patient satisfaction was observed in the medial pivot group using KSS (satisfaction and expectations elements) and OKS at 4-year follow-up.…”

Comparison of Postoperative Effects between Medial Pivot Prosthesis and Posterior Stabilized Prosthesis

“…Lee et al . reported that there was no evidence of the superiority of MPTKA over PSTKA in terms of preference and satisfaction 13 . Lin et al .…”

“…However, some studies have found no statistical difference between these two designs with respect to clinical outcomes. Lee et al reported that there was no evidence of the superiority of MPTKA over PSTKA in terms of preference and satisfaction 13 . Lin et al reached similar conclusions in a retrospective study 14 .…”