Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2017

01-11-2017 | Knee

Better functional outcome after single-radius TKA compared with multi-radius TKA

Authors: Isabel Collados-Maestre, Alejandro Lizaur-Utrilla, Blanca Gonzalez-Navarro, Francisco A. Miralles-Muñoz, Luis Marco-Gomez, Fernando A. Lopez-Prats, Vicente Gil-Guillen

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2017

Login to get access

Abstract

Purpose

To determine whether the design of the femoral component influenced patient outcomes.

Methods

Two hundred and thirty-seven patients were randomized to compare functional outcomes between single-radius TKA (SR, 118 patients) and multi-radius TKA (MR, 119 patients) with a minimum follow-up of 5 years. Prospective pre- and postoperative assessments were performed by the clinical and radiological criteria of the Knee Society Score (KSS), WOMAC and Short-Form 12 (SF12) questionnaires. The extension mechanism was assessed based on the quadriceps strength and chair test. Patient satisfaction was also assessed.

Results

The median follow-up was 5.7 (range 5–7) years. At last follow-up, significant better KSSs (p = 0.001), range of motion (p = 0.001), extension lag (p = 0.020), quadriceps strength (p = 0.004), chair test (p = 0.032) and WOMAC pain (p = 0.002) were found in the SR group. Moreover, the improvements of these variables were early in the SR group (from 6 postoperative months). There were no significant differences in WOMAC function or SF12 physical and mental components. The revision rate and implant survival were similar in both groups. Satisfaction rate was significantly higher in SR group (p = 0.032).

Conclusion

This study shows better results with SR cruciate-retaining femoral component than MR component. The use of SR system is recommended because, although the clinically relevant differences were moderate, the functional improvement was earlier and the patient satisfaction higher with this design.

Level of evidence

Therapeutic study, Level I.
Literature
1.
go back to reference Bellamy N, Buchanan W, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip and the knee. J Rheumatol 15:1833–1840PubMed Bellamy N, Buchanan W, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip and the knee. J Rheumatol 15:1833–1840PubMed
2.
go back to reference Cook LE, Klika AK, Szubsk CR, Rosneck J, Molloy R, Barsoum WK (2012) Functional outcomes used to compare single radius and multiradius of curvature designs in total knee arthroplasty. J Knee Surg 25:249–253CrossRefPubMed Cook LE, Klika AK, Szubsk CR, Rosneck J, Molloy R, Barsoum WK (2012) Functional outcomes used to compare single radius and multiradius of curvature designs in total knee arthroplasty. J Knee Surg 25:249–253CrossRefPubMed
3.
go back to reference D’Lima DD, Poole C, Chadha H, Hermida JC, Mahar A, Colwell CW Jr (2001) Quadriceps moment arm and quadriceps forces after total knee arthroplasty. Clin Orthop Relat Res 392:213–220CrossRef D’Lima DD, Poole C, Chadha H, Hermida JC, Mahar A, Colwell CW Jr (2001) Quadriceps moment arm and quadriceps forces after total knee arthroplasty. Clin Orthop Relat Res 392:213–220CrossRef
4.
go back to reference Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12 Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12
5.
go back to reference Gómez-Barrena E, Fernandez-García C, Fernandez-Bravo A, Cutillas-Ruiz R, Bermejo-Fernandez G (2010) Functional performance with a single-radius femoral design total knee arthroplasty. Clin Orthop Relat Res 468:1214–1220CrossRefPubMed Gómez-Barrena E, Fernandez-García C, Fernandez-Bravo A, Cutillas-Ruiz R, Bermejo-Fernandez G (2010) Functional performance with a single-radius femoral design total knee arthroplasty. Clin Orthop Relat Res 468:1214–1220CrossRefPubMed
6.
go back to reference Hall J, Copp SN, Adelson WS, D’Lima DD, Colwell CW Jr (2008) Extensor mechanism function in single-radius vs multiradius femoral components for total knee arthroplasty. J Arthroplasty 23:216–219CrossRefPubMed Hall J, Copp SN, Adelson WS, D’Lima DD, Colwell CW Jr (2008) Extensor mechanism function in single-radius vs multiradius femoral components for total knee arthroplasty. J Arthroplasty 23:216–219CrossRefPubMed
7.
go back to reference Hamilton DF, Burnett R, Patton JT, Howie CR, Moran M, Simpson AH, Gaston P (2015) Implant design influences patient outcome after total knee arthroplasty: a prospective double-blind randomised controlled trial. Bone Joint J 97:64–70CrossRefPubMed Hamilton DF, Burnett R, Patton JT, Howie CR, Moran M, Simpson AH, Gaston P (2015) Implant design influences patient outcome after total knee arthroplasty: a prospective double-blind randomised controlled trial. Bone Joint J 97:64–70CrossRefPubMed
8.
go back to reference Hinarejos P, Puig-Verdie L, Leal J, Pelfort X, Torres-Claramunt R, Sánchez-Soler J, Monllau JC (2015) No differences in functional results and quality of life after single-radius or multiradius TKA. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-015-3894-z Hinarejos P, Puig-Verdie L, Leal J, Pelfort X, Torres-Claramunt R, Sánchez-Soler J, Monllau JC (2015) No differences in functional results and quality of life after single-radius or multiradius TKA. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-015-3894-z
9.
go back to reference Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14 Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14
10.
go back to reference Jo AR, Song EK, Lee KB, Seo HY, Kim SK, Seon JK (2014) A comparison of stability and clinical outcomes in single-radius versus multi-radius femoral design for total knee arthroplasty. J Arthroplasty 29:2402–2406CrossRefPubMed Jo AR, Song EK, Lee KB, Seo HY, Kim SK, Seon JK (2014) A comparison of stability and clinical outcomes in single-radius versus multi-radius femoral design for total knee arthroplasty. J Arthroplasty 29:2402–2406CrossRefPubMed
11.
go back to reference Kim DH, Kim DK, Lee SH, Kim KI, Bae DK (2015) Is single-radius design better for quadriceps recovery in total knee arthroplasty? Knee Surg Relat Res 27:240–246CrossRefPubMedPubMedCentral Kim DH, Kim DK, Lee SH, Kim KI, Bae DK (2015) Is single-radius design better for quadriceps recovery in total knee arthroplasty? Knee Surg Relat Res 27:240–246CrossRefPubMedPubMedCentral
12.
go back to reference Larsen B, Jacofsky MC, Jacofsky DJ (2015) Quantitative, comparative assessment of gait between single-radius and multi-radius total knee arthroplasty designs. J Arthroplasty 30:1062–1067CrossRefPubMed Larsen B, Jacofsky MC, Jacofsky DJ (2015) Quantitative, comparative assessment of gait between single-radius and multi-radius total knee arthroplasty designs. J Arthroplasty 30:1062–1067CrossRefPubMed
13.
go back to reference Liu S, Long H, Zhang Y, Ma B, Li Z (2016) Meta-Analysis of outcomes of a single-radius versus multi-radius femoral design in total knee arthroplasty. J Arthroplasty 31:646–654CrossRefPubMed Liu S, Long H, Zhang Y, Ma B, Li Z (2016) Meta-Analysis of outcomes of a single-radius versus multi-radius femoral design in total knee arthroplasty. J Arthroplasty 31:646–654CrossRefPubMed
15.
go back to reference Mahoney OM, McClumg CD, Delaosa MA, Schmalzried TP (2002) The effect of total knee arthroplasty design on extensor mechanism function. J Arthroplasty 17:416–421CrossRefPubMed Mahoney OM, McClumg CD, Delaosa MA, Schmalzried TP (2002) The effect of total knee arthroplasty design on extensor mechanism function. J Arthroplasty 17:416–421CrossRefPubMed
16.
go back to reference Mizner RL, Snyder-Mackler L (2005) Altered loading during walking and sit-to-stand is affected by quadriceps weakness after total knee arthroplasty. J Orthop Res 23:1083–1090CrossRefPubMed Mizner RL, Snyder-Mackler L (2005) Altered loading during walking and sit-to-stand is affected by quadriceps weakness after total knee arthroplasty. J Orthop Res 23:1083–1090CrossRefPubMed
17.
go back to reference Mugnai R, Digennaro V, Ensini A, Leardini A, Catani F (2015) Can TKA design affect the clinical outcome? Comparison between two guided-motion systems. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-013-2509-9 Mugnai R, Digennaro V, Ensini A, Leardini A, Catani F (2015) Can TKA design affect the clinical outcome? Comparison between two guided-motion systems. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-013-2509-9
18.
go back to reference Noble PC, Conditt MA, Cook KF, Mathis KB (2006) The John Insall award: patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 452:35–43CrossRefPubMed Noble PC, Conditt MA, Cook KF, Mathis KB (2006) The John Insall award: patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 452:35–43CrossRefPubMed
19.
20.
go back to reference Palmer J, Sloan K, Clark G (2014) Functional outcomes comparing Triathlon versus Duracon total knee arthroplasty: does the Triathlon outperform its predecessor? Int Orthop 38:1375–1378CrossRefPubMedPubMedCentral Palmer J, Sloan K, Clark G (2014) Functional outcomes comparing Triathlon versus Duracon total knee arthroplasty: does the Triathlon outperform its predecessor? Int Orthop 38:1375–1378CrossRefPubMedPubMedCentral
21.
go back to reference Rand JA (2003) Extensor mechanism complications following total knee arthroplasty. J Knee Surg 16:224–228PubMed Rand JA (2003) Extensor mechanism complications following total knee arthroplasty. J Knee Surg 16:224–228PubMed
22.
go back to reference Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L (2000) Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand 71:262–267CrossRefPubMed Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L (2000) Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand 71:262–267CrossRefPubMed
23.
go back to reference Wang H, Simpson KJ, Ferrara MS, Chamnongkich S, Kinsey T, Mahoney OM (2006) Biomechanical differences exhibited during sit-to-stand between total knee arthroplasty designs of varying radii. J Arthroplasty 21:1193–1199CrossRefPubMed Wang H, Simpson KJ, Ferrara MS, Chamnongkich S, Kinsey T, Mahoney OM (2006) Biomechanical differences exhibited during sit-to-stand between total knee arthroplasty designs of varying radii. J Arthroplasty 21:1193–1199CrossRefPubMed
24.
go back to reference Ware JE Jr, Kosinski M, Keller SD (1996) A 12-item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233CrossRefPubMed Ware JE Jr, Kosinski M, Keller SD (1996) A 12-item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233CrossRefPubMed
Metadata
Title
Better functional outcome after single-radius TKA compared with multi-radius TKA
Authors
Isabel Collados-Maestre
Alejandro Lizaur-Utrilla
Blanca Gonzalez-Navarro
Francisco A. Miralles-Muñoz
Luis Marco-Gomez
Fernando A. Lopez-Prats
Vicente Gil-Guillen
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4273-0

Other articles of this Issue 11/2017

Knee Surgery, Sports Traumatology, Arthroscopy 11/2017 Go to the issue