Patient-Reported Outcomes following Single- and Multiple-Radius Total Knee Replacement: A Randomized, Controlled Trial

Mushtaq, Nadeem; Liddle, Alexander D.; Isaac, David; Dillow, Katherine; Gill, Paul

doi:10.1055/s-0037-1602132

Cited by 4 publications

(9 citation statements)

References 23 publications

(25 reference statements)

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“…We identified 595 articles initially through both online and manual searches undertaken up to February 2020. After we applied the exclusion criteria, ultimately nine RCTs remained to be analyzed in this meta-analysis [14,[19][20][21][22][23][24][25][26] (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

“…These findings correlated with the results of the randomized studies that focused on the postoperative functional outcomes. Mushtaq et al [25] compared 54 patients with MR and 51 with SR and observed no significant differences in KSS and OKS. Moreover, Jo et al [21] compared 50 patients with SR and 50 with MR, and found no significant differences in HSS score, ROM, and WOMAC either.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of functional outcomes between single-radius and multi-radius femoral components in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Kim

Min

Lee³

et al. 2020

Knee Surg & Relat Res

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Purpose Our purpose in the current meta-analysis was to compare the functional outcomes in patients who have received single-radius (SR) or multi-radius (MR) femoral components in randomized controlled trials (RCTs) for primary total knee arthroplasty (TKA). The hypothesis was that there would be no statistically significant difference between two groups in terms of functional outcomes. Materials and methods We searched the international electronic databases PubMed, Embase, and the Cochrane Central Register of Controlled Trials up to February 2020 for RCTs that compared functional outcomes of SR and MR femoral component designs after primary TKA. We performed a meta-analysis of nine RCTs using the Knee Society Score for the knee (KSS-knee), KSS-function, Knee Injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), degree of knee flexion, extension, and complications, including postoperative infection and revision surgery. Results The meta-analysis revealed no statistically significant differences in all the analyzed variables, including KSS-knee, KSS-function, KOOS, OKS, knee flexion, and knee extension. For postoperative complications, no statistically significant differences were detected for femoral component designs in postoperative infection or incidence of revision surgery between the two groups. Conclusions The current meta-analysis of RCTs did not show any statistically significant differences between SR and MR femoral component designs in terms of postoperative functional outcomes. Evaluated outcomes included functional outcome scores, degree of knee flexion, extension, and complications. However, because of the limited clinical evidence of this study owing to the heterogeneity between the included RCTs, a careful approach should be made in order not to arrive at definite conclusions.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of functional outcomes between single-radius and multi-radius femoral components in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Kim

Min

Lee³

et al. 2020

Knee Surg & Relat Res

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“…Patella tilt, patella height, patella thickness, and delta angle were predictors of secondary patella resurfacing when different variants (CR, PS, condylar constrained) of a multiradius patella-friendly TKA design were compared [49]. In an RCT, a single radius was compared to a multiradius design and no differences were found when OKS and KSS scores were used [50]. 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].…”

Section: Discussionmentioning

confidence: 99%

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

Karachalios

Komnos

Hantes

et al. 2021

The Journal of Arthroplasty

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Background: Patella-friendly femoral components were developed in order to reduce anterior knee pain and patellofemoral complications in total knee arthroplasty (TKA), but their effect on long-term outcome is still unclear. Methods: We retrospectively evaluated prospectively collected data from 3 groups consisting of 100 patients (100 knees in each). In group A, the constant radius a-MP, in group B the multiradius cruciateretaining Genesis II, and in group C the nonanatomic, multiradius, cruciate-retaining AGC TKA was implanted. Patients of all groups were matched for age, gender, side, body mass index, and length of follow-up. Preoperative and postoperative clinical outcome data in the form of Knee Society System (KSS), Short Form-12, Western Ontario and McMaster University Osteoarthritis Index, and Oxford Knee Score were available at regular intervals for groups A and B. For patients of group C, KSS score data were available at the same time intervals. In all groups, the patellofemoral compartment was assessed using the Clinical Patella Score scale. Anterior knee pain, secondary patella resurfacing, implant failure, and radiological outcome were assessed in patients of all groups. Results: At 10-year and 15-year follow-up, patients of group A showed statistically significant (s.s.) higher (all P ¼ .000) KSS values as compared to those of groups B and C. At 15-year follow-up, patients of group B showed s.s. higher (P ¼ .001) KSS values as compared to those of group C. At 10-year and 15-year follow up, patients of group A showed s.s. higher (all P ¼ .00) Western Ontario and McMaster University Osteoarthritis Index and Oxford Knee Score values as compared to those of group B. At 15-year follow-up only, patients of group A showed s.s. higher (P ¼ .00) Short Form-12 (physical) values as compared to those of group B. In terms of Clinical Patella Score, patients in group A had s.s. higher values (P ¼ .05) when compared to those of groups B and C. Anterior knee pain was recorded in 4.4% of TKAs in group A, 7.5% in group B, and 17.2% in group C. One (1.1%) patient in group A, 3 (3.25%) in group B, and 7 (8%) in group C underwent secondary resurfacing. Conclusion: Anatomical, patella-friendly, constant radius femoral components outperform others in reducing anterior knee pain and patella complications in TKA in which the patellae are left nonresurfaced.

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“…The baseline data of included studies was summarized in Table 1. A total of 13 RCTs 7,17,18,20,23,[26][27][28]33,35,42,44,45 All patients included in these studies suffered from degenerative knee arthritis. The SR knee prosthesis used in included studies comprised Scorpion, Scorpion NRG, Triathlon, and Trekking knee system.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…However, the inclusion of some retrospective studies limits its reliability. In addition, many RCTs have been published from then on, among which the controversy still persists 20 , 21 , 22 , 23 , 25 , 26 . Therefore, it is strongly necessary to update this meta‐analysis only including prospective randomized controlled trials to determine whether there were clinical advantages to SR‐TKA over MR‐TKA.…”

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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Patient-Reported Outcomes following Single- and Multiple-Radius Total Knee Replacement: A Randomized, Controlled Trial

Cited by 4 publications

References 23 publications

Comparison of functional outcomes between single-radius and multi-radius femoral components in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Comparison of functional outcomes between single-radius and multi-radius femoral components in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

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

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

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