Patient satisfaction at 2 months following total knee replacement using a second generation medial-pivot system: follow-up of 250 consecutive cases

Abstract

Background: Patient dissatisfaction following total knee replacement (TKR) has been reported as high as 24%.Most previous studies have focused on satisfaction for TKR overall, with few reporting satisfaction for specific implant designs. The purpose of this study was to assess patient satisfaction for TKRs performed using a second generation medial-pivot system (EVOLUTION ® , MicroPort Orthopedics Inc., Arlington, TN, USA).Methods: Of a single surgeon's first 250 consecutive TKRs performed using the subject system, 224 completed a patient satisfaction assessment, the Knee Injury and Osteoarthritis Outcome Score (KOOS), range of motion, and radiographs at 2 months follow-up. Results:The overall very satisfied/satisfied rate was 94.6% at 2 months. Following the first 50 TKRs, the satisfied rate improved to 99.4% suggesting a bias towards the initial cases potentially due to learning the system and instrumentation. Overall KOOS, range of motion, and radiographic outcomes were satisfactory at final follow-up. Conclusions:In conclusion, more subjects implanted with a second generation medial-pivot system were satisfied compared to previous reports for TKR.

A Medial Congruent Polyethylene Offers Satisfactory Early Outcomes and Patient Satisfaction in Total Knee Arthroplasty

“…Previous medially stabilized knee designs have shown good patient satisfaction and survivorship at early, midterm, and long-term follow-up. Van Overschelde and Fitch showed high patient satisfaction using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Knee Society Score (KSS) at 2 months immediately after TKA with the Evolution Medial-Pivot knee (MicroPort Orthopedics) [ 14 ]. After the first 50 cases, 99.4% of patients were reported to be satisfied or very satisfied.…”

Sagittal Stability and Implant Design Affect Patient Reported Outcomes After Total Knee Arthroplasty

“…This was particularly true when patients were asked if they were aware of their knee when standing from a low-sitting position; an activity that requires mid-flexion stability [8]. No significant difference was seen between the MS TKA and the non-MS TKA groups according to VAS patient satisfaction, likely due to the well-recognized ceiling effect of VAS [17].…”

“…The average follow-up time in this study was 13.8 and 15.8 months for the MS and non-MS groups, respectively. It has been previously reported that patient satisfaction reaches a plateau at between 6 months and 12 months; therefore, with ongoing follow-up of this cohort currently underway, it will be interesting to determine the relationship between sagittal stability and patient satisfaction persists in the long term [17,19]. Further analysis regarding the precise relationship between the conformity ration and the kinematics of the TKA bearing surface are indicated; either by in vitro cadaveric or in vivo fluoroscopic studies, or potentially using finite element analysis and three-dimensional solid modeling.…”

Comparison of Clinical Outcomes Between Total Knee Arthroplasties Using Medial-Pivot and Posterior-Stabilized Prosthesis: Minimum 8-year Follow-up Results in Chinese population

“…Therefore, the placement of the prosthesis, the balance of space for flexion and extension, and the degree of soft tissue release all require delicate manipulation when performing the movable platform exercises. To solve this problem, the second generation EVOLUTION medial-pivot knee prosthesis launched by Wright has made considerable improvements in terms of increasing knee flexion and stability [18]. However, the long-term clinical effect of this new prosthesis needs to be further confirmed by follow-ups.…”