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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-04-2019 | KNEE

Modern TKA implants are equivalent to traditional TKA implants in functional and patellofemoral joint-related outcomes

Authors: Jia Long Chua, Graham Seow-Hng Goh, Ming Han Lincoln Liow, Darren Keng-Jin Tay, Ngai-Nung Lo, Seng-Jin Yeo

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2019

Abstract

Purpose

To compare patient-reported outcomes measures, health-related quality of life and satisfaction rates between a new Modern TKA system (M-TKA) and an existing Traditional TKA system (T-TKA).

Methods

Prospectively collected registry data of 65 patients who underwent T-TKA and 65 patients who underwent M-TKA at a single institution from 2014 to 2015 was reviewed. The range of motion, Knee Society Knee Score (KSKS), Function Score (KSFS), Oxford Knee Score (OKS), SF-36, satisfaction and expectation fulfilment were compared at Pre-op, 6 months and 2 years. Patellofemoral joint-related OKS subscores (3, 5, 7, 12) were also compared between the groups. Minimal clinically important difference (MCID) in OKS/SF-36 were analysed for both groups. Propensity scores generated using logistic regression were used to adjust for confounding variables, thus allowing matching of T-TKA to M-TKA in a 1:1 ratio.

Results

Both groups showed a significant improvement in all measured variables at 6 month and 2 years (p < 0.001) when compared to baseline. There was no significant difference in KSKS, KSFS, OKS, SF-36 and Patellofemoral joint-related OKS subscores (3, 5, 7, 12) between the two groups (n.s.). At 2 years, there were high satisfaction rates of 89.2% and 92.2% in the T-TKA and M-TKA groups, respectively (n.s.). Similarly, both groups demonstrated high expectation fulfilment rates of 84.6% and 90.6% for the T-TKA and M-TKA groups, respectively (n.s.).

Conclusion

Using an extensive battery of standardized patient-reported, health-related quality of life and MCID assessments, our study demonstrated no difference in clinical outcomes between M-TKA and T-TKA that would justify the use of the newer and costlier M-TKA. Longer follow-up is necessary to evaluate the possible advantages of this new implant design.

Level of evidence

Level III, Retrospective Study.

Bin Abd Razak HR, Tan C-S, Chen YJD, Pang H-N, Tay K-JD, Chin P-L, Chia S-L, Lo N-N, Yeo S-J (2016) Age and preoperative knee society score are significant predictors of outcomes among asians following total knee arthroplasty. J Bone Jt Surg Am 98:735–741CrossRef

Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KDJ (2010) Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop 468:57–63CrossRefPubMed

Breugem SJM, Haverkamp D (2014) Anterior knee pain after a total knee arthroplasty: what can cause this pain? World J Orthop 5:163–170CrossRefPubMedPubMedCentral

Breugem SJM, Sierevelt IN, Schafroth MU, Blankevoort L, Schaap GR, van Dijk CN (2008) Less anterior knee pain with a mobile-bearing prosthesis compared with a fixed-bearing prosthesis. Clin Orthop 466:1959–1965CrossRefPubMed

Carey BW, Harty J (2018) A comparison of clinical- and patient-reported outcomes of the cemented ATTUNE and PFC Sigma fixed bearing cruciate sacrificing knee systems in patients who underwent total knee replacement with both prostheses in opposite knees. J Orthop Surg 13:54CrossRef

Cook CE (2008) Clinimetrics corner: the Minimal Clinically Important Change Score (MCID): a necessary pretense. J Man Manip Ther 16:E82–E83CrossRefPubMedPubMedCentral

Dennis DA, Kim RH, Johnson DR, Springer BD, Fehring TK, Sharma A (2011) The John Insall Award: control-matched evaluation of painful patellar Crepitus after total knee arthroplasty. Clin Orthop 469:10–17CrossRefPubMed

Escobar A, Gonzalez M, Quintana JM, Vrotsou K, Bilbao A, Herrera-Espiñeira C, Garcia-Perez L, Aizpuru F, Sarasqueta C (2012) Patient acceptable symptom state and OMERACT-OARSI set of responder criteria in joint replacement. Identification of cut-off values. Osteoarthr Cartil 20:87–92CrossRefPubMed

Goh GS-H, Liow MHL, Pang H-N, Tay DK-J, Lo N-N, Yeo S-J (2018) Patients with poor baseline mental health undergoing unicompartmental knee arthroplasty have poorer outcomes. J Arthroplast 33:2428–2434CrossRef

10.

Goh GS-H, Liow MHL, Tay DK-J, Lo NN, Yeo SJ (2015) Four-year follow up outcome study of patellofemoral arthroplasty at a single institution. J Arthroplast 30:959–963CrossRef

11.

Hirschmann MT, Testa E, Amsler F, Friederich NF (2013) The unhappy total knee arthroplasty (TKA) patient: higher WOMAC and lower KSS in depressed patients prior and after TKA. Knee Surg Sports Traumatol Arthrosc 21:2405–2411CrossRefPubMed

12.

Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop 248:13–14

13.

Jacobs CA, Christensen CP (2014) Factors influencing patient satisfaction two to five years after primary total knee arthroplasty. J Arthroplast 29:1189–1191CrossRef

14.

Judge A, Arden NK, Cooper C, Kassim Javaid M, Carr AJ, Field RE, Dieppe PA (2012) Predictors of outcomes of total knee replacement surgery. Rheumatol Oxf Engl 51:1804–1813CrossRef

15.

Lim JTK, Luscombe KL, Jones PW, White SH (2006) The effect of preoperative symptom severity on functional outcome of total knee replacement—patients with the lowest preoperative scores achieve the lowest marks. Knee 13:216–219CrossRefPubMed

16.

Lingard EA, Katz JN, Wright EA, Sledge CB, Kinemax Outcomes Group (2004) Predicting the outcome of total knee arthroplasty. J Bone Jt Surg Am 86-A:2179–2186CrossRef

17.

Martin JR, Jennings JM, Watters TS, Levy DL, McNabb DC, Dennis DA (2017) Femoral implant design modification decreases the incidence of patellar crepitus in total knee arthroplasty. J Arthroplast 32:1310–1313CrossRef

18.

Murray DW, Fitzpatrick R, Rogers K, Pandit H, Beard DJ, Carr AJ, Dawson J (2007) The use of the Oxford hip and knee scores. J Bone Jt Surg Br 89:1010–1014CrossRef

19.

Nakahara H, Okazaki K, Mizu-Uchi H, Hamai S, Tashiro Y, Matsuda S, Iwamoto Y (2015) Correlations between patient satisfaction and ability to perform daily activities after total knee arthroplasty: why aren’t patients satisfied? J Orthop Sci 20:87–92CrossRefPubMed

20.

Noble PC, Conditt MA, Cook KF, Mathis KB (2006) The John Insall Award: patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop 452:35–43CrossRefPubMed

21.

Quintana JM, Escobar A, Bilbao A, Arostegui I, Lafuente I, Vidaurreta I (2005) Responsiveness and clinically important differences for the WOMAC and SF-36 after hip joint replacement. Osteoarthr Cartil 13:1076–1083CrossRefPubMed

22.

Ranawat CS, White PB, West S, Ranawat AS (2017) Clinical and radiographic results of attune and PFC Sigma knee designs at 2-year follow-up: a prospective matched-pair analysis. J Arthroplast 32:431–436CrossRef

23.

Rothwell AG, Hooper GJ, Hobbs A, Frampton CM (2010) An analysis of the Oxford hip and knee scores and their relationship to early joint revision in the New Zealand Joint Registry. J Bone Jt Surg Br 92:413–418CrossRef

24.

Scott CEH, Howie CR, MacDonald D, Biant LC (2010) Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Jt Surg Br 92:1253–1258CrossRef

25.

Sharkey PF, Lichstein PM, Shen C, Tokarski AT, Parvizi J (2014) Why are total knee arthroplasties failing today—has anything changed after 10 years? J Arthroplast 29:1774–1778CrossRef

26.

Song SJ, Park CH, Liang H, Kang SG, Park JJ, Bae DK (2018) Comparison of clinical results and injury risk of posterior tibial cortex between attune and press fit condylar sigma knee systems. J Arthroplast 33:391–397CrossRef

27.

Werth L, Saffarini M, Amsler F, Abdelkafy A, Hirschmann MT (2017) The need for secondary resurfacing is affected by trochlear height in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 25:3818–3823CrossRefPubMed

28.

Williams DP, Blakey CM, Hadfield SG, Murray DW, Price AJ, Field RE (2013) Long-term trends in the Oxford knee score following total knee replacement. Bone Jt Surg 95-B:45–51CrossRef

Title: Modern TKA implants are equivalent to traditional TKA implants in functional and patellofemoral joint-related outcomes
Authors: Jia Long Chua
Graham Seow-Hng Goh
Ming Han Lincoln Liow
Darren Keng-Jin Tay
Ngai-Nung Lo
Seng-Jin Yeo
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-018-5161-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Modern TKA implants are equivalent to traditional TKA implants in functional and patellofemoral joint-related outcomes

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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Correction to: Femoral insertion site of the graft used to replace the medial patellofemoral ligament influences the ligament dynamic changes during knee flexion and the clinical outcome