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
. 2024 Jul 17:58:154-160.
doi: 10.1016/j.jor.2024.07.011. eCollection 2024 Dec.

The influence of implant factors on patient outcomes in primary total knee arthroplasty

Jan Peter Van Meirhaeghe  1   2 , Ian A Harris  3 , Alana Cuthbert  4 , Michelle Lorimer  4 , Michael McAuliffe  5   6 , Sam Adie  7   8 , Robert Molnar  7   8
Affiliations

The influence of implant factors on patient outcomes in primary total knee arthroplasty

Jan Peter Van Meirhaeghe et al. J Orthop. .

Abstract

Background: The influence of implant factors on patient-reported outcome measures (PROMS) after total knee arthroplasty (TKA) has previously been studied but findings are often inconsistent, restricted in scope and biased by confounding factors. This study aims to determine the association between implant-related factors and early post-operative PROMs after TKA.

Methods: Using data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) PROMs program, the study included 9487 primary TKA procedures performed in 43 hospitals from July 31, 2018 to December 31, 2020. Data included baseline demographic data, surgical details and PROMs collected pre- and 6 months post-operatively. Seven prosthesis characteristics were incorporated in the multivariable model, with proportional odds ordinal regression analysis used to assess their effects on post-operative Oxford knee score (OKS) and joint pain. Adjustments were made for pre-operative OKS and joint pain, as well as potential patient confounders.

Results: At six months, fixed bearing implants showed higher odds of better OKS compared to mobile bearing implants (odds ratio [OR] = 1.20, 95 % confidence interval [CI] 1.06-1.37. p < 0.004). Similar findings were found with the use of image derived instrumentation (IDI) (OR = 1.27, 95 % CI 1.11-1.46, p < 0.001), robotic assisted vs. non-navigated knees (OR = 1.21, 95 % CI 1.06-1.38, p < 0.005) and no patella resurfacing (OR = 1.10, 95 % CI 1.01-1.20, p < 0.032). For lower pain scores at six months, the use of highly crosslinked polyethylene (OR = 1.12, 95 % CI 1.02-1.22, p < 0.015), cemented femoral components (OR = 1.11, 95 % CI 1.01-1.22, p < 0.024), IDI (OR = 1.20, 95 % CI 1.05-1.37, p < 0.009) or no patella resurfacing (OR = 1.10, 95 % CI 1.01-1.20, p < 0.034) were associated.

Conclusion: Utilizing a fixed bearing or robotic assistance correlated with improved OKS scores, whereas highly crosslinked polyethylene or cemented femoral components were associated with improved pain scores. At six months, the use of IDI compared to non-navigated TKA, and patellar resurfacing showed both improved OKS and pain scores.

Keywords: Implant characteristics; Outcomes; PROMs; Primary knee arthroplasty.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Singleton N., Nicholas B., Gormack N., Stokes A. Differences in outcome after cruciate retaining and posterior stabilized total knee arthroplasty. J Orthop Surg. 2019;27(2) - PubMed
    1. Li N., Tan Y., Deng Y., Chen L. Posterior cruciate-retaining versus posterior stabilized total knee arthroplasty: a meta-analysis of randomized controlled trials. Knee Surg Sports Traumatol Arthrosc. 2014;22(3):556–564. - PubMed
    1. Serna-Berna R., Lizaur-Utrilla A., Vizcaya-Moreno M.F., Miralles Muñoz F.A., Gonzalez-Navarro B., Lopez-Prats F.A. Cruciate-retaining vs posterior-stabilized primary total arthroplasty. Clinical outcome comparison with a minimum follow-up of 10 years. J Arthroplasty. 2018;33(8):2491–2495. - PubMed
    1. van den Boom L.G.H., Brouwer R.W., van den Akker-Scheek I., et al. No difference in recovery of patient-reported outcome and range of motion between cruciate retaining and posterior stabilized total knee arthroplasty: a double-blind randomized controlled trial. J Knee Surg. 2020;33(12):1243–1250. - PubMed
    1. Sun X., Gao X., Sun X., Su Z. Comparison of clinical and radiographic results between total knee arthroplasties using medial pivot and posterior-stabilized prosthesis: a meta-analysis. Medicine. 2021;100(4) - PMC - PubMed

LinkOut - more resources