Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2024 May;144(5):2327-2335.
doi: 10.1007/s00402-024-05340-3. Epub 2024 Apr 23.

Performance of medial pivot, posterior stabilized and rotating platform total knee arthroplasty based on anteroposterior stability and patient-reported outcome measures; a multicentre double-blinded randomized controlled trial of 210 knees

Affiliations
Randomized Controlled Trial

Performance of medial pivot, posterior stabilized and rotating platform total knee arthroplasty based on anteroposterior stability and patient-reported outcome measures; a multicentre double-blinded randomized controlled trial of 210 knees

J D De Groot et al. Arch Orthop Trauma Surg. 2024 May.

Erratum in

Abstract

Background: Despite advancements in total knee arthroplasty (TKA), 10-20% of patients remain dissatisfied after surgery. Improved anteroposterior (AP) stability provided by medial pivot (MP) implants may theoretically lead to higher patient satisfaction.

Methods: AP stability and patient-reported outcome measures (PROMs) at one-year postsurgery were compared between patients who underwent TKA with MP- (n = 121), posterior stabilized (PS; n = 53) and rotating platform (RP; n = 57) implants in a double-blind multicentre randomized controlled trial (Dutch Trial Register: NL6856, 21-02-2018). AP stability was assessed at 30°, 60° and 90° of knee flexion using a KT-2000 arthrometer. PROMs were measured preoperative and one-year postsurgery.

Results: MP-TKA provided significant better AP stability at early flexion (30°) compared to PS- and RP-TKA (median [IQR]; 1.79 [1.14-2.77] mm vs. 3.31 [2.51-4.08] mm vs. 2.82 [1.80-4.03] mm, p < 0.001). Additionally, MP-TKA provided significant better AP stability at mid-flexion (60°) compared to PS-TKA (1.75 [1.23-2.36] mm vs. 2.14 [1.49-2.83] mm, p = 0.014). PROM improvements were comparable between implant designs. AP laxity of ≥ 4 mm at early flexion was independently of implant design associated with significantly worse Kujala scores. The incidence of ≥ 4 mm AP laxity at any knee angle was however not significantly different between implant designs.

Conclusion: MP-, PS- and RP-TKA all provide excellent and comparable results. Although MP-TKA provided better AP stability at early flexion compared to PS- and RP-TKA, this was found to be unrelated to improved PROMs in favour of MP-TKA. More studies focusing on early and mid-flexion performance based differences between MP and other TKA designs are required to confirm our findings. Other non-implant related factors may play a more important role in the performance of TKA and are potentially worthwhile examining.

Keywords: Anteroposterior stability; Medial pivot; Patient related outcome measurements; Posterior stabilized; Rotating platform; Total knee arthroplasty.

PubMed Disclaimer

References

    1. Dall’Oca C, Ricci M, Vecchini E, Giannini N, Lamberti D, Tromponi C et al (2017) Evolution of TKA design. Acta Biomed 88(2S):17–31. https://doi.org/10.23750/abm.v88i2-S.650 - DOI - PubMed - PMC
    1. Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD (2010) Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res 468(1):57–63. https://doi.org/10.1007/s11999-009-1119-9 - DOI - PubMed
    1. DeFrance MJ, Scuderi GR (2023) Are 20% of patients actually dissatisfied following total knee arthroplasty? A systematic review of the literature. J Arthroplasty 38(3):594–599. https://doi.org/10.1016/j.arth.2022.10.011 - DOI - PubMed
    1. Ayers DC, Yousef M, Zheng H, Yang W, Franklin PD (2022) The prevalence and predictors of patient dissatisfaction 5-years following primary total knee arthroplasty. J Arthroplasty 37(6S):S121–S128. https://doi.org/10.1016/j.arth.2022.02.077 - DOI - PubMed
    1. Gunaratne R, Pratt DN, Banda J, Fick DP, Khan RJK, Robertson BW (2017) Patient dissatisfaction following total knee arthroplasty: a systematic review of the literature. J Arthroplasty 32(12):3854–3860. https://doi.org/10.1016/j.arth.2017.07.021 - DOI - PubMed

Publication types

LinkOut - more resources