Second-generation bi-cruciate stabilized total knee system has a lower reoperation and revision rate than its predecessor
| Autor: | Branko Kopjar, Bernhard Christen |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Reoperation Risk medicine.medical_specialty Complications Knee Joint Total knee arthroplasty Kaplan-Meier Estimate Lower risk Total knee Bi-cruciate stabilized Cohort Studies 03 medical and health sciences Postoperative Complications 0302 clinical medicine Humans Medicine Orthopedics and Sports Medicine Revision rate Longitudinal Studies Knee Arthroplasty Arthroplasty Replacement Knee Aged Retrospective Studies Aged 80 and over 030222 orthopedics business.industry Hazard ratio Revisions 030229 sport sciences General Medicine Middle Aged Prosthesis Failure Surgery Orthopedic surgery Cohort Guided motion Female Reoperations Knee Prosthesis business Cohort study |
| Zdroj: | Archives of Orthopaedic and Trauma Surgery |
| ISSN: | 1434-3916 0936-8051 |
| DOI: | 10.1007/s00402-018-3019-5 |
| Popis: | Introduction Total knee arthroplasty (TKA) can provide pain relief and good long-term results. However, nearly 30% of post-surgical patients are unsatisfied due to persistent pain and functional deficits. A second-generation bi-cruciate stabilized TKA device has a post-cam mechanism with an asymmetric femoral component, a polyethylene insert, and a medially concave and laterally convex shape. The device is designed to provide guided motion, and thus improve knee kinematics by more closely approximating a normal knee. The aim of this study was to evaluate early complication and revision rates of the second-generation device and to compare its clinical performance to the first-generation device. Materials and methods In this retrospective, longitudinal, non-concurrent cohort study, 140 TKAs were performed using the second-generation device on 131 patients from 2012 to 2016, and 155 TKAs were performed using the first-generation device on 138 patients from 2009 to 2012. Primary outcomes were occurrence of revisions and reoperations. Results There were 31 reoperations [3.21 per 100 observed component years (OCY)] in 22 (2.28 per 100 OCY) TKAs in the first-generation device cohort compared to five reoperations (1.92 per 100 OCY) in four TKAs (1.54 per 100 OCY) in the second-generation device cohort. The adjusted hazard ratio (HR) was 3.50 (P = 0.0254). There were 21 revisions (2.17 per 100 OCY) in 16 (1.66 per 100 OCY) TKAs in the first-generation device cohort, compared to only three revisions (1.15 per 100 OCY) in two TKAs (0.77 per 100 OCY) in the second-generation device cohort. The adjusted HR was 4.16 (P = 0.0693). Conclusion The improved design of the second-generation device appears to be associated with a lower risk of reoperation and revision compared to that of the first-generation device. Level of evidence III. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink