Third-generation posterior-stabilised cemented system for total knee arthroplasty: Survivorship and outcomes after 20-year follow-up.

Autor: Patiño Contreras JL; Department of Orthopedic Surgery Hospital Universitario Fundación Alcorcón Alcorcón Madrid Spain., Sebastián Pérez V; Department of Orthopedic Surgery Hospital Universitario Fundación Alcorcón Alcorcón Madrid Spain., Antonio CG; Department of Orthopedic Surgery Hospital Universitario Fundación Alcorcón Alcorcón Madrid Spain., Jorge MS; Department of Orthopedic Surgery Hospital Universitario Fundación Alcorcón Alcorcón Madrid Spain., Javier MM; Department of Orthopedic Surgery Hospital Universitario Fundación Alcorcón Alcorcón Madrid Spain.
Jazyk: angličtina
Zdroj: Journal of experimental orthopaedics [J Exp Orthop] 2024 Jun 22; Vol. 11 (3), pp. e12063. Date of Electronic Publication: 2024 Jun 22 (Print Publication: 2024).
DOI: 10.1002/jeo2.12063
Abstrakt: Purpose: Total knee arthroplasty is a common procedure due to increased life expectancy and ageing populations, necessitating implants with long-term efficacy. After some initial designs, the third-generation modular posterior-stabilised NexGen® prosthesis aimed to enhance kinematics and reduce complications. This study evaluates the long-term outcomes, survivorship, revision rates and complications of this implant. With promising results observed up to 15 years in previous studies, this investigation aims to assess the implant's performance over extended follow-up periods, aiding in optimal implant selection for improved patient outcomes.
Methods: We carried out a retrospective study on 263 total knee arthroplasties performed in our centre between 1998 and 2002. Statistical analysis of complications was performed and study of survival using the Kaplan-Meier method and competing risk analysis were calculated. Description of reinterventions and complications were also included.
Results: Results show a 20-year prosthesis survival rate of 90.8% for revision due to any reason, with an estimated survival of 92.3% considering competitive events. Estimated survivorship at 20 years is 98% for aseptic loosening as the end point, and an estimation of 98.80% considering competitive events. Twenty revisions were performed, with 10 cases due to infection and 10 for noninfectious reasons and three of them due to aseptic loosening. Radiographic analysis revealed radiolucent lines, but no clinical evidence of loosening was observed in these cases.
Conclusion: This study offers survivorship data from longer follow-up periods, what is difficult to find in the reported literature and showed excellent results of this implant in terms of survivorship and low rates of revision in our cohort.
Level of Evidence: Level IV.
Competing Interests: Javier Martínez Martín collaborates as a consultant for Zimmer Biomet. The remaining authors declare no conflict of interest.
(© 2024 The Author(s). Journal of Experimental Orthopaedics published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)
Databáze: MEDLINE
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