No differences in functional results and quality of life after single-radius or multiradius TKA

Hinarejos, Pedro; Leal, Joan; Pelfort, Xavier; Torres-Claramunt, Raúl; Sánchez-Soler, Juan; Monllau, Joan Carles

doi:10.1007/s00167-015-3894-z

Cited by 13 publications

(17 citation statements)

References 27 publications

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“…Favourable Knee Society Scores have been reported by Harwin et al [23] in 2035 Triathlon TKAs in 1688 patients with 48-point improvements for pain and 22 for function at a mean of 21 months. Other non-randomised studies have found no differences in PROMs between single- and multi-radius posterior-stabilised TKAs [24]. …”

Section: Discussionmentioning

confidence: 99%

Excellent 10-year patient-reported outcomes and survival in a single-radius, cruciate-retaining total knee arthroplasty

Scott

Bell

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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PurposeOver 2 million Triathlon single-radius total knee arthroplasties (TKAs) have been implanted worldwide. This study reports the 10-year survival and patient-reported outcome of the Triathlon TKA in a single independent centre.MethodsFrom 2006 to 2007, 462 consecutive cruciate-retaining Triathlon TKAs were implanted in 426 patients (median age 69 (21–89), 289 (62.5%) female). Patellae were not routinely resurfaced. Patient-reported outcome measures (SF-12, Oxford Knee Scores (OKS), satisfaction) were assessed preoperatively and at 1, 5 and 10 years when radiographs were reviewed. Forgotten Joint Scores (FJS) were collected at 10 years. Kaplan–Meier survival analysis was performed.ResultsAt 10–11.6 years, 123 patients (128 TKAs) had died and 8 TKAs were lost to follow-up. There were four aseptic failures (two cases of tibial loosening, two cases of instability) and four septic failures requiring revision. Symptomatic aseptic radiographic loosening was present in three further cases at 11 years. Four (1%) patellae were secondarily resurfaced. OKS score improved by 17.7 ± 9.7 points at 1 year (p < 0.001), and was maintained at 34.7 ± 9.6 at 10 years with FJS 48.5 ± 31.4. Patient satisfaction was 88% at each timepoint. Ten-year survival was 97.9% (95% confidence interval 96.5–99.3) for revision for any reason, 98.9% (97.7–100) for mechanical failure, and 98.6% (97.4–99.8) for aseptic loosening (symptomatic radiographic or revised).ConclusionThe Triathlon TKA continues to show excellent longer-term results with high implant survivorship, low rates of aseptic failure, consistently maintained PROMs and excellent patient satisfaction rates of 88% at 10 years.Level of evidenceII, Prospective cohort study.

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Section: Discussionmentioning

confidence: 99%

Excellent 10-year patient-reported outcomes and survival in a single-radius, cruciate-retaining total knee arthroplasty

Scott

Bell

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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“…Due to the ongoing pursuit of optimising the longevity and performance of the prosthesis, there are many prosthetic designs available ( 4 ). These constructs have emerged based on many published in vivo studies of the knee motion, as well as biomechanical theories of knee kinematics such as single radius ( 5 ), multi radii ( 6 ), fixed–bearing ( 7 ), mobile–bearing ( 8 ), posterior stabilized ( 9 ), cruciate retaining ( 10 ), and cruciate sacrificing ( 11 ). In Australia alone, there have been 119 femoral and tibial prosthesis combinations used in primary TKJR reported to the National Joint Replacement Registry ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of Clinical Functional Outcomes After Medial Stabilized Versus Non-Medial Stabilized Total Knee Joint Replacement

et al. 2018

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Background Medial stabilized total knee joint replacement (TKJR) construct is designed to closely replicate the kinematics of the knee. Little is known regarding comparison of clinical functional outcomes of patients utilising validated patient reported outcome measures (PROM) after medial stabilized TKJR and other construct designs.PurposeTo perform a systematic review of the available literature related to the assessment of clinical functional outcomes following a TKJR employing a medial stabilized construct design.MethodsThe review was performed with a Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) algorithm. The literature search was performed using variouscombinations of keywords. The statistical analysis was completed using Review Manager (RevMan), Version 5.3.ResultsIn the nineteen unique studies identified, there were 2,448 medial stabilized TKJRs implanted in 2,195 participants, there were 1,777 TKJRs with non-medial stabilized design constructs implanted in 1,734 subjects. The final mean Knee Society Score (KSS) value in the medial stabilized group was 89.92 compared to 90.76 in the non-medial stabilized group, with the final KSS mean value difference between the two groups was statistically significant and favored the non-medial stabilized group (SMD 0.21; 95% CI: 0.01 to 0.41; p = 004). The mean difference in the final WOMAC values between the two groups was also statistically significant and favored the medial stabilized group (SMD: −0.27; 95% CI: −0.47 to −0.07; p = 0.009). Moderate to high values (I2) of heterogeneity were observed during the statistical comparison of these functional outcomes.ConclusionBased on the small number of studies with appropriate statistical analysis, we are unable to reach a clear conclusion in the clinical performance of medial stabilized knee replacement construct.Level of EvidenceLevel II

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“…The single-radius design theoretically could avoid inconsistent movement of femoral component and extend the moment arm of extension mechanism when the knee was moderately flexed [15][16][17] . Despite the theoretical advantages of single-radius femoral component, many clinical studies comparing the clinical outcome of SR-TKA and MR-TKA have come to contradictory conclusions [18][19][20][21][22][23] . Meanwhile, Liu et al 24 performed a comprehensive meta-analysis to compare SR-TKA and MR-TKA, reaching the conclusion that no clinical superiority for SR-TKA over MR-TKA was found, with lower knee range of motion in the SR-TKA group.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Single‐Radius with Multiple‐Radius Femur in Total Knee Arthroplasty: A Meta‐Analysis of Prospective Randomized Controlled Trials

Lei

Jiang

et al. 2022

Orthopaedic Surgery

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Background Whether there was clinical superiority for the single‐radius prosthesis over the multi‐radius prothesis in total knee arthroplasty (TKA) still remains to be clarified. We updated a meta‐analysis including prospective randomized controlled trials (RCTs) to compare the clinical prognosis of patients receiving single‐radius TKA (SR‐TKA) or multi‐radius TKA (MR‐TKA). Methods We searched the databases of PubMed, Web of Science, EMBASE, Cochrane Library, MEDLINE for eligible RCTs. Two reviewers evaluated the study quality according to the Risk of Bias tool of the Cochrane Library and extracted the data in studies individually. The extracted data included the baseline data and clinical outcome. The baseline data include the author's name, country, and year of included studies, the name of knee prosthesis used in studies, sample size, follow‐up time, and BMI of patients. The clinical data comprised primary indicators including postoperative knee range of motion (ROM), sit‐to‐stand rest, severe postoperative scorings, such as visual analog scale (VAS), American Knee Society knee score (AKS), Oxford knee scoring (OKS), and SF‐36 Quality of Life Scale, as well as various secondary indicators of complications including anterior knee pain, postoperative infection, aseptic prosthesis loosening, and prosthesis revision. The data analysis was performed using Review Manager 5.3 software and STATA 12.0. The sensitivity analysis was performed using STATA 12.0. Results A total of 13 RCTs, along with 1720 patients and 1726 knees, were finally included in our present meta‐analysis. We found that patients in SR‐TKA group performed better in the sit‐to‐stand test (OR = 1.89, 95% CI: 1.05–3.41, p = 0.03) and satisfaction evaluation (OR = 3.27, 95% CI: 1.42–7.53, p = 0.005), which were only evaluated in two included RCTs. While no significant difference was found between SR‐TKA and MR‐TKA groups in terms of postoperative ROM, VAS scoring, AKS scoring, SF‐36 scoring, OKS scoring, and various complications including anterior knee pain, postoperative infection, aseptic prosthesis loosening, and prosthesis revision. Conclusion In conclusion, our present meta‐analysis indicated that SR implants were noninferior to MR implants in TKA, and SR implants could be an alternative choice over MR implants, since patients after SR‐TKA felt more satisfied and performed better in the sit‐to‐stand test, with no significant difference in complications between SR‐TKA and MR‐TKA groups. While more relevant clinical trials with long‐term follow‐up time and specific tests evaluating the function of knee extension mechanism should be carried out to further investigate the clinical performance of SR implants.

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No differences in functional results and quality of life after single-radius or multiradius TKA

Abstract: Therapeutic study: Prospective comparative study, Level II.

Cited by 13 publications

References 27 publications

Excellent 10-year patient-reported outcomes and survival in a single-radius, cruciate-retaining total knee arthroplasty

Excellent 10-year patient-reported outcomes and survival in a single-radius, cruciate-retaining total knee arthroplasty

A Systematic Review of Clinical Functional Outcomes After Medial Stabilized Versus Non-Medial Stabilized Total Knee Joint Replacement

Comparison of Single‐Radius with Multiple‐Radius Femur in Total Knee Arthroplasty: A Meta‐Analysis of Prospective Randomized Controlled Trials

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