A New Total Knee Arthroplasty Design Has Significantly Better Early Implant Survivorship than a Previous Gold-Standard Design—A Retrospective Analysis of 1,000 Cases

Benjamin V. Bloch; Jeya Palan; Mohammad Shahid; Peter J. James

doi:10.1055/s-0038-1676770

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2020; 33(02): 152-157
DOI: 10.1055/s-0038-1676770

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A New Total Knee Arthroplasty Design Has Significantly Better Early Implant Survivorship than a Previous Gold-Standard Design—A Retrospective Analysis of 1,000 Cases

Benjamin V. Bloch

¹Nottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, United Kingdom

,

Jeya Palan

¹Nottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, United Kingdom

,

Mohammad Shahid

¹Nottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, United Kingdom

,

Peter J. James

¹Nottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, United Kingdom

› Author Affiliations

Abstract

This study examined whether a new total knee arthroplasty (TKA) prosthesis improved implant survivorship and reoperation rates compared with a gold-standard, established TKA. A retrospective analysis of the first 500 consecutive new TKAs was compared with a consecutive series of the last 500 currently available TKAs performed by a single senior surgeon in one center. The primary outcome measure was revision of the femoral, tibial, or patellar component. A secondary outcome was reoperation for any reason. The new-TKA group had a significantly reduced revision rate at up to 5 years follow-up (p = 0.02). Reoperation rates for any reason were similar (p = 0.3). The new TKA design has a significantly better early revision rate compared with a currently available gold-standard TKA. This is the largest study of 1,000 cases comparing a new TKA design with a currently available design with excellent midterm results. It demonstrates very favorable early clinical results for the new TKA design, providing reassurance for patients, surgeons, and regulatory bodies.

Keywords

knee arthroplasty - design - outcome - survivorship

Full Text

References

References
1 No authors listed. National Joint Registry 14th Annual Report 2017. Available at: https://www.hqip.org.uk/resource/national-joint-registry-14th-annual-report-2017/#.W__J7_ZuIid . Accessed November 29, 2018
2 Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007; 89 (04) 780-785
3 Scott CEH, Howie CR, MacDonald D, Biant LC. Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Joint Surg Br 2010; 92 (09) 1253-1258
4 Dunbar MJ, Haddad FS. Patient satisfaction after total knee replacement: new inroads. Bone Joint J 2014; 96-B (10) 1285-1286
5 Scott CEH, Oliver WM, MacDonald D, Wade FA, Moran M, Breusch SJ. Predicting dissatisfaction following total knee arthroplasty in patients under 55 years of age. Bone Joint J 2016; 98-B (12) 1625-1634
6 Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 2006; 452: 35-43
7 Scott CEH, Bugler KE, Clement ND, MacDonald D, Howie CR, Biant LC. Patient expectations of arthroplasty of the hip and knee. J Bone Joint Surg Br 2012; 94 (07) 974-981
8 Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KDJ. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?. Clin Orthop Relat Res 2010; 468 (01) 57-63
9 Baker PN, van der Meulen JH, Lewsey J, Gregg PJ. ; National Joint Registry for England and Wales; Data from the National Joint Registry for England and Wales. The role of pain and function in determining patient satisfaction after total knee replacement. J Bone Joint Surg Br 2007; 89 (07) 893-900
10 Hamilton DF, Lane JV, Gaston P. , et al. What determines patient satisfaction with surgery? A prospective cohort study of 4,709 patients following total joint replacement. BMJ Open 2013; 3 (04) e002525-e002528
11 Lane JV, Hamilton DF, MacDonald DJ, Ellis C, Howie CR. Factors that shape the patient's hospital experience and satisfaction with lower limb arthroplasty: an exploratory thematic analysis. BMJ Open 2016; 6 (05) e010871
12 Shannak O, Palan J, Esler C. A regional registry study of 216 patients investigating if patient satisfaction after total knee arthroplasty changes over a time period of five to 20years. Knee 2017; 24 (04) 824-828
13 Becker R, Hirschmann MT, Karlsson J. Does implant design and surgical technique improve the clinical outcome in total knee arthroplasty?. Knee Surg Sports Traumatol Arthrosc 2014; 22 (08) 1716-1718
14 Nunley RM, Nam D, Berend KR. , et al. New total knee arthroplasty designs: do young patients notice?. Clin Orthop Relat Res 2015; 473 (01) 101-108
15 Kim Y-H, Park J-W, Kim J-S. Clinical outcome of medial pivot compared with press-fit condylar sigma cruciate-retaining mobile-bearing total knee arthroplasty. J Arthroplasty 2017; 32 (10) 3016-3023
16 Hossain F, Patel S, Rhee S-J, Haddad FS. Knee arthroplasty with a medially conforming ball-and-socket tibiofemoral articulation provides better function. Clin Orthop Relat Res 2011; 469 (01) 55-63
17 Gustke KA, Golladay GJ, Roche MW, Jerry GJ, Elson LC, Anderson CR. Increased satisfaction after total knee replacement using sensor-guided technology. Bone Joint J 2014; 96-B (10) 1333-1338
18 Huang T, Long Y, George D, Wang W. Meta-analysis of gap balancing versus measured resection techniques in total knee arthroplasty. Bone Joint J 2017; 99-B (02) 151-158
19 Thienpont E, Schwab PE, Fennema P. A systematic review and meta-analysis of patient-specific instrumentation for improving alignment of the components in total knee replacement. Bone Joint J 2014; 96-B (08) 1052-1061
20 Nam D, Nunley RM, Berend KR, Lombardi AV, Barrack RL. The impact of custom cutting guides on patient satisfaction and residual symptoms following total knee arthroplasty. Knee 2016; 23 (01) 144-148
21 Spencer JM, Chauhan SK, Sloan K, Taylor A, Beaver RJ. Computer navigation versus conventional total knee replacement: no difference in functional results at two years. J Bone Joint Surg Br 2007; 89 (04) 477-480
22 Burnett RSJ, Barrack RL. Computer-assisted total knee arthroplasty is currently of no proven clinical benefit: a systematic review. Clin Orthop Relat Res 2013; 471 (01) 264-276
23 Kim Y-H, Park J-W, Kim J-S. 2017 Chitranjan S. Ranawat award: does computer navigation in knee arthroplasty improve functional outcomes in young patients? A randomized study. Clin Orthop Relat Res 2018; 476 (01) 6-15
24 Whittaker J-P, Dwyer KA, Howard J. , et al. Leearning curve with a new primary TKA implant: a worldwide perspective with more than 2000 patients. Arthroplast Today 2018; 4 (03) 348-353
25 Fisher DA, Trimble SM, Breedlove K. The medial trivector approach in total knee arthroplasty. Orthopedics 1998; 21 (01) 53-56
26 Venous thromboembolism: reducing the risk for patients in hospital, clinical guideline (CG92). National Institute for Health and Care Excellence (NICE). Available from: https://www.nice.org.uk/Guidance/CG92 . Accessed November 29, 2018
27 Phillips JR, James P. Orthopaedics in the UK is ahead of proposed regulations for incremental innovation in medical devices. BMJ 2014; 349: g5894
28 Nieuwenhuijse MJ, Nelissen RGHH, Schoones JW, Sedrakyan A. Appraisal of evidence base for introduction of new implants in hip and knee replacement: a systematic review of five widely used device technologies. BMJ 2014; 349: g5133
29 Clary CW, Fitzpatrick CK, Maletsky LP, Rullkoetter PJ. The influence of total knee arthroplasty geometry on mid-flexion stability: an experimental and finite element study. J Biomech 2013; 46 (07) 1351-1357
30 Pfitzner T, Moewis P, Stein P. , et al. Modifications of femoral component design in multi-radius total knee arthroplasty lead to higher lateral posterior femoro-tibial translation. Knee Surg Sports Traumatol Arthrosc 2018; 26 (06) 1645-1655
31 Etter K, Lerner J, Kalsekar I, de Moor C, Yoo A, Swank M. Comparative analysis of hospital length of stay and discharge status of two contemporary primary total knee systems. J Knee Surg 2018; 31 (06) 541-550
32 Ranawat CS, White PB, West S, Ranawat AS. Clinical and radiographic results of attune and PFC Sigma knee designs at 2-year follow-up: a prospective matched-pair analysis. J Arthroplasty 2017; 32 (02) 431-436
33 Martin JR, Jennings JM, Watters TS, Levy DL, McNabb DC, Dennis DA. Femoral implant design modification decreases the incidence of patellar crepitus in total knee arthroplasty. J Arthroplasty 2017; 32 (04) 1310-1313
34 Indelli PF, Pipino G, Johnson P, Graceffa A, Marcucci M. Posterior-stabilized total knee arthroplasty: a matched pair analysis of a classic and its evolutional design. Arthroplast Today 2016; 2 (04) 193-198
35 Toomey SD, Daccach JA, Shah JC, Himden SE, Lesko JP, Hamilton WG. Comparative incidence of patellofemoral complications between 2 total knee arthroplasty systems in a multicenter, prospective clinical study. J Arthroplasty 2017; 32 (9S): S187-S192
36 Song SJ, Park CH, Liang H, Kang SG, Park JJ, Bae DK. Comparison of clinical results and injury risk of posterior tibial cortex between attune and press fit condylar sigma knee systems. J Arthroplasty 2018; 33 (02) 391-397
37 Dwyer K, Jones RE, Lesko J, Leopold J, Diaz R. ATTUNE knee system early performance: minimum two year clinical results. Available from: http://synthes.vo.llnwd.net/o16/LLNWMB8/US%20Mobile/Synthes%20North%20America/Product%20Support%20Materials/White%20Papers/DSUSJRC10140506_ATTUNE_2year_WP.pdf . Accessed March 1, 2018
38 Australian orthopaedic association national joint replacement registry annual report 2017. Available from: https://aoanjrr.sahmri.com/ . Accessed November 29, 2018
39 Clark CR, Rorabeck CH, MacDonald S, MacDonald D, Swafford J, Cleland D. Posterior-stabilized and cruciate-retaining total knee replacement: a randomized study. Clin Orthop Relat Res 2001; (392) 208-212
40 Jacobs WCH, Clement DJ, Wymenga AB. Retention versus removal of the posterior cruciate ligament in total knee replacement: a systematic literature review within the Cochrane framework. Acta Orthop 2005; 76 (06) 757-768
41 Luo S-X, Zhao JM, Su W, Li X-F, Dong G-F. Posterior cruciate substituting versus posterior cruciate retaining total knee arthroplasty prostheses: a meta-analysis. Knee 2012; 19 (04) 246-252
42 Kolisek FR, McGrath MS, Marker DR. , et al. Posterior-stabilized versus posterior cruciate ligament-retaining total knee arthroplasty. Iowa Orthop J 2009; 29: 23-27
43 Bercik MJ, Joshi A, Parvizi J. Posterior cruciate-retaining versus posterior-stabilized total knee arthroplasty: a meta-analysis. J Arthroplasty 2013; 28 (03) 439-444
44 Jiang C, Liu Z, Wang Y, Bian Y, Feng B, Weng X. Posterior cruciate ligament retention versus posterior stabilization for total knee arthroplasty: a meta-analysis. PLoS One 2016; 11 (01) e0147865-e15
45 Nouta KA, Verra WC, Pijls BG, Schoones JW, Nelissen RGHH. All-polyethylene tibial components are equal to metal-backed components: systematic review and meta-regression. Clin Orthop Relat Res 2012; 470 (12) 3549-3559
46 Price AJ, Rees JL, Beard D. , et al. A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. A multicentre single-blind randomised controlled trial. J Bone Joint Surg Br 2003; 85 (01) 62-67
47 Kim Y-H, Yoon S-H, Kim J-S. The long-term results of simultaneous fixed-bearing and mobile-bearing total knee replacements performed in the same patient. J Bone Joint Surg Br 2007; 89 (10) 1317-1323
48 Breeman S, Campbell MK, Dakin H. , et al; KAT Trial Group. Five-year results of a randomised controlled trial comparing mobile and fixed bearings in total knee replacement. Bone Joint J 2013; 95-B (04) 486-492
49 Orthopaedic Data Evaluation Panel. Available from: http://www.odep.org.uk . Accessed May 3, 2018