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
- PMID: 38653837
- DOI: 10.1007/s00402-024-05340-3
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
Erratum in
-
Correction to: 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.Arch Orthop Trauma Surg. 2024 Aug;144(8):3899. doi: 10.1007/s00402-024-05388-1. Arch Orthop Trauma Surg. 2024. PMID: 38896277 No abstract available.
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.
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
References
-
- 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
-
- 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
-
- 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
-
- 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
-
- 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
MeSH terms
LinkOut - more resources
Full Text Sources
Medical