A Prospective Randomized Study Comparing Postoperative Pain, Biological Fixation, and Clinical Outcomes Between Two Uncemented Rotating Platform Tibial Tray Designs
| Autor: | Paul Hegarty, Laurence Cusick, Andrew Walls, David E. Beverland, Seamus O'Brien, Barbara Gamble |
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| Rok vydání: | 2020 |
| Předmět: |
Osteolysis
Radiodensity medicine.medical_treatment Dentistry Prosthesis Design Prosthesis Osseointegration 03 medical and health sciences Fixation (surgical) 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Prospective Studies Arthroplasty Replacement Knee Pain Postoperative 030222 orthopedics Rehabilitation Tibia business.industry medicine.disease Arthroplasty Prosthesis Failure Implant Knee Prosthesis business Follow-Up Studies |
| Zdroj: | The Journal of Arthroplasty. 35:429-437 |
| ISSN: | 0883-5403 |
| Popis: | Background With the demand for arthroplasty increasing worldwide year on year, there is a drive to improve prosthesis longevity. Biological fixation from cementless implants has been one method of trying to achieve this. We hypothesized that the addition of a hydroxyapatite (HA) coating and 4 pegs to a porous-coated tibial tray would provide a reduction in time to implant osseointegration, allowing for normal physiological stress transfer, thus improving early postoperative pain and rehabilitation as well as the elimination of radiolucent lines (RLLs). Methods A prospective, randomized controlled single-blinded study was undertaken, comparing postoperative pain, radiographic evidence of biological fixation, and clinical outcomes between patients undergoing primary total knee arthroplasty with either LCS Complete POROCOAT (porous coating only) or LCS Complete DUOFIX (porous coating plus HA and pegs) knee systems (DePuy Synthes, Warsaw, IN). In total, 197 patients (205 knees) were recruited into the study between November 2006 and November 2008 and have been followed for up to 10 years. Results There were no clinically significant differences in pain or patient-reported outcome measures when comparing the 2 designs but the tibial tray with pegs and HA showed fewer RLLs at all time points. There was no correlation between RLLs and pain and no instances of loosening or osteolysis in either group. There was 1 revision for infection in the porous coating only group. Conclusion The tray design with HA and additional fixation pegs did not confer any benefit in terms of reduced early postoperative pain or improved patient-reported outcomes, although it did result in significantly fewer RLLs. Both implants demonstrated excellent survivorship. With a cementless porous-coated tibial component, nonprogressive RLLs should be considered normal. |
| Databáze: | OpenAIRE |
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