A matched comparison of revision rates of cemented Oxford Unicompartmental Knee Replacements with Single and Twin Peg femoral components, based on data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man

Autor: Gulraj S. Matharu, Hasan R Mohammad, David W. Murray, Andrew Judge
Rok vydání: 2020
Předmět:
Male
Reoperation
medicine.medical_specialty
Knee Prosthesis/adverse effects
medicine.medical_treatment
Northern Ireland
macromolecular substances
Unicompartmental knee replacement
Arthroplasty
Replacement
Knee/instrumentation
Northern ireland
Prosthesis Failure/adverse effects
03 medical and health sciences
0302 clinical medicine
Humans
Medicine
Orthopedics and Sports Medicine
Registries
030212 general & internal medicine
England/epidemiology
Femoral component
Arthroplasty
Replacement
Knee
Wales/epidemiology
Aged
Retrospective Studies
Orthopedic surgery
Northern Ireland/epidemiology
030222 orthopedics
Wales
United Kingdom/epidemiology
business.industry
General surgery
technology
industry
and agriculture
Articles
General Medicine
Arthroplasty
United Kingdom
Prosthesis Failure
Reoperation/statistics & numerical data
England
Unicompartmental knee
England wales
Female
Surgery
Knee Prosthesis
business
RD701-811
Research Article
Zdroj: Acta Orthopaedica, Vol 91, Iss 4, Pp 420-425 (2020)
Acta Orthopaedica
article-version (VoR) Version of Record
Mohammad, H R, Matharu, G S, Judge, A & Murray, D W 2020, ' A matched comparison of revision rates of cemented Oxford Unicompartmental Knee Replacements with Single and Twin Peg femoral components, based on data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man ', Acta Orthopaedica, vol. 91, no. 4, pp. 420-425 . https://doi.org/10.1080/17453674.2020.1748288
ISSN: 1745-3682
1745-3674
DOI: 10.1080/17453674.2020.1748288
Popis: Background and purpose — Registries report high revision rates after unicompartmental knee replacement (UKR) due, in part, to aseptic loosing. In an attempt to improve Oxford UKR femoral component fixation a new design was introduced with a Twin rather than a Single peg. We used the National Joint Registry (NJR) to compare the 5-year outcomes of the Single and Twin Peg cemented Oxford UKRs. Patients and methods — We performed a retrospective observational study using NJR data on propensity score matched Single and Twin Peg UKRs (matched for patient, implant and surgical factors). Data on 2,834 Single Peg and 2,834 Twin Peg were analyzed. Cumulative implant survival was calculated using the Kaplan–Meier method and comparisons between groups performed using Cox regression models. Results — In the matched cohort, the mean follow up for both Single and Twin Peg UKRs was 3.3 (SD 2) and 3.4 years (SD 2) respectively. The 5-year cumulative implant survival rates for Single Peg and Twin Peg were 94.8% (95% CI 93.6–95.8) and 96.2% (CI 95.1–97.1) respectively. Implant revision rates were statistically significantly lower in the Twin Peg (hazard ratio [HR)] = 0.74; p = 0.04). The revision rate for femoral component aseptic loosening decreased significantly (p = 0.03) from 0.4% (n = 11) with the Single Peg to 0.1% (n = 3) with the Twin Peg. The revision rate for pain decreased significantly (p = 0.01) from 0.8% (n = 23) with the Single Peg to 0.3% (n = 9) with the Twin Peg. No other reasons for revision had significant differences in revision rates. Interpretation — The revision rate for the cemented Twin Peg Oxford UKR was 26% less than the Single Peg Oxford UKR. This was mainly because the revision rates for femoral loosening and pain more than halved. This suggests that the Twin Peg component should be used in preference to the Single Peg design.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje