Two-year RSA migration results of symmetrical and asymmetrical tibial components in total knee arthroplasty: a randomized controlled trial

Koster, Lennard A; Meinardi, Joris E.; Kaptein, Bart L; Zwaag, Enrike Van Der Linden Van Der; Nelissen, Rob G H H

doi:10.1302/0301-620x.103b5.bjj-2020-1575.r2

Cited by 23 publications

(17 citation statements)

References 31 publications

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“…8 It is really good to see this addition to the increasing number of randomized studies in knee arthroplasty surgery. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Colleagues in trauma surgery are also making good use of registry data when looking at mortality, 26 and after rarer procedures, such as distal femoral arthroplasty for fracture. 27 This provides useful, albeit incomplete, information and will guide our practice and generate questions that can be addressed in future studies.…”

Section: The International Hip Society Meeting 2021mentioning

confidence: 99%

The International Hip Society Meeting 2021

Haddad

Malchau

2022

The Bone & Joint Journal

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Section: The International Hip Society Meeting 2021mentioning

confidence: 99%

The International Hip Society Meeting 2021

Haddad

Malchau

2022

The Bone & Joint Journal

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“…The countries with the most authors were from the United Kingdom in seven reports, 11,12,23,[30][31][32][33] Japan in four reports, 13,[34][35][36] South Korea in three reports, [14][15][16] and two reports each for both the People's Republic of China 17,18 and the Netherlands. 19,20 There was one report each from Australia, 21 Austria, 22 Canada, 24 Denmark, 25 Germany, 26 India, 27 Singapore, 28 and Turkey (►Table 2). 29…”

Section: Countries Of Originmentioning

confidence: 99%

Robust Randomized Controlled Data Is Lacking in Total Joint Arthroplasty

et al. 2022

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Introduction: Randomized controlled trials (RCTs)are regarded as highest level of scientific evidence. There is belief that while prospective randomized control trials (PRCTs) are the gold standard for evaluating efficacy of interventions, there are very few conducted on lower extremity joint arthroplasty. However, there was a more than adequate amount (n=197) of published RCTs in knee arthroplasty during the 2021 calendar year. Therefore, we studied RCTs on knee arthroplasties for 2021 and assessed them for overall study topic reasons (i.e., devices as well as prostheses, rehabilitation, pain control, blood loss [tranexamic acid], and other), which were then subcategorized by: (1) country of origin; (2) sample size; and (3)whether or not they were follow-up studies. After this, we specifically focused on the studies (n=26) concerning devices or prostheses. Methods: A search of PubMed on “knee arthroplasty” specifying “RCT” using their search function and dates between January 1, 2021 to December 24, 2021 resulted in the analyzed reports. A total of 17.3% reports analyzed rehabilitation methods while 28.4% studied pain control. A total of 20.3% examined blood loss topics and 20.8% investigated other topics. Results: We found that 26 studies (13.2%) involved prosthetic design and implantation. Overall, only 15% knee arthroplasty RCTs were conducted in the United States, the mean total final sample size was 133±146 patients, and 7% were follow-up studies. None of the prostheses studies were performed in the United States, and the mean total final sample size of all of these studies was 86±54 patients, and 23% were follow-up studies. Total knee arthroplasty prospective RCTs were not performed in the United States. Conclusion: The authors believe that other study designs, such as database or registry analyses, are also appropriate in this rapidly advancing field of joint arthroplasty for the continuing evaluation and approval of new prostheses and techniques, while we await more PRCTs in our field.

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“…Modelbased RSA has overcome the difficulties with the attachment of markers to the component by using 3D surface models, 10 allowing analysis of the migration of the femoral component, resulting in several recent publications. [11][12][13][14] The Attune cementless rotating platform TKA was introduced in 2016 and is the successor of the cementless Low Contact Stress (LCS) Complete rotating platform prosthesis (both DePuy Synthes, USA). The LCS TKA has a good clinical track record with rates of survival of > 95% five years postoperatively.…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial comparing two-year postoperative femoral and tibial migration of a new and an established cementless rotating platform total knee arthroplasty

Koster

Rassir

Kaptein

et al. 2023

The Bone & Joint Journal

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Aims The primary aim of this study was to compare the migration of the femoral and tibial components of the cementless rotating platform Attune and Low Contact Stress (LCS) total knee arthroplasty (TKA) designs, two years postoperatively, using radiostereometric analysis (RSA) in order to assess the risk of the development of aseptic loosening. A secondary aim was to compare clinical and patient-reported outcome measures (PROMs) between the designs. Methods A total of 61 TKAs were analyzed in this randomized clinical RSA trial. RSA examinations were performed one day and three, six, 12, and 24 months postoperatively. The maximal total point motion (MPTM), translations, and rotations of the components were analyzed. PROMs and clinical data were collected preoperatively and at six weeks and three, six, 12, and 24 months postoperatively. Linear mixed effect modelling was used for statistical analyses. Results The mean MTPM two years postoperatively (95% confidence interval (CI)) of the Attune femoral component (0.92 mm (0.75 to 1.11)) differed significantly from that of the LCS TKA (1.72 mm (1.47 to 2.00), p < 0.001). The Attune femoral component subsided, tilted (anteroposteriorly), and rotated (internal-external) significantly less. The mean tibial MTPM two years postoperatively did not differ significantly, being 1.11 mm (0.94 to 1.30) and 1.17 mm (0.99 to 1.36, p = 0.447) for the Attune and LCS components, respectively. The rate of migration in the second postoperative year was negligible for the femoral and tibial components of both designs. The mean pain-at-rest (numerical rating scale (NRS)-rest) in the Attune group was significantly less compared with that in the LCS group during the entire follow-up period. At three months postoperatively, the Knee injury and Osteoarthritis Outcome Physical Function Shortform score, the Oxford Knee Score, and the NRS-activity scores were significantly better in the Attune group. Conclusion The mean MTPM of the femoral components of the cementless rotating platform Attune was significantly less compared with that of the LCS design. This was reflected mainly in significantly less subsidence, posterior tilting, and internal rotation. The mean tibial MTPMs were not significantly different. During the second postoperative year, the components of both designs stabilized and low risks for the development of aseptic loosening are expected. Cite this article: Bone Joint J 2023;105-B(2):148–157.

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Two-year RSA migration results of symmetrical and asymmetrical tibial components in total knee arthroplasty: a randomized controlled trial

Cited by 23 publications

References 31 publications

The International Hip Society Meeting 2021

The International Hip Society Meeting 2021

Robust Randomized Controlled Data Is Lacking in Total Joint Arthroplasty

A randomized controlled trial comparing two-year postoperative femoral and tibial migration of a new and an established cementless rotating platform total knee arthroplasty

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