A comparison between cemented, press-fit, and HA-coated interfaces in Kinemax total knee replacement

Walker, Peter S.; Sathasivam, Shivani; Cobb, A. G.; Learmonth, Ian D.; Grobler, G; Pinder, I. M.; Marchetti, N; Spinelli, M; Welsby, A

doi:10.1016/s0968-0160(99)00041-1

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…Concerning the outcome of durability as measured by failure at 2 years (requiring revision), there was found to be no difference between HA-coated and cemented MB tibial components. While the trial by Walker et al (2000) did not use an endpoint that was similar to the others (i.e. MTPM > 0.2 in 2 years), it did demonstrate that the use of HA coating on a press-fit metal-backed implant provided significantly less micromotion than a press-fit metal-backed implant only.…”

Section: Discussionmentioning

confidence: 75%

“…Durability as defined above by Ryd et al (1995) (MTPM of > 0.2 mm in 2 years for prediction of loosening at 10 years) or abject failure could not be examined in the paper by Walker et al (2000), as the analyses performed in this trial examined migration in the implant groups only (HA press-fit vs. MB press-fit vs. MB cemented) and did not define failure based on the definition by Ryd et al (1995). What was found was that migration based on the Walker definition was statistically significantly higher in the MB press-fit group than in the HA press-fit or MB cemented groups when examined for axial migration (p-values not stated).…”

Section: Resultsmentioning

confidence: 99%

“…The functional status (as assessed using the KSS) of Walker et al (2000) was evaluated based on data presented in the trial, which demonstrated no statistically significant difference between the groups from the KSS score at 2 years (p-values not available) (HA press-fit vs. MB press-fit vs. MB cemented).…”

Section: Resultsmentioning

confidence: 99%

“…Only 3 trials evaluated patients < 65 years of age (Walker et al (2000, Nilsson et al 2006, Beaupré et al 2007). These studies could not be combined on the durability endpoint due to the fact that different endpoints were analyzed (Beaupré et al (2007) had a primary endpoint of durability (revision) at 5 years; Nilsson et al 2006) had a primary endpoint of durability (MPTM > 0.2 mm in 2 years), and Walker et al (2000) had a primary endpoint of functional status measured with KSS only, and there was insufficient data available).…”

Section: Resultsmentioning

confidence: 99%

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Hydroxyapatite (HA) coating appears to be of benefit for implant durability of tibial components in primary total knee arthroplasty

Voigt¹,

Mosier²

2011

Acta Orthopaedica

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BackgroundIt is unclear whether there is a clinical benefit to adding hydroxyapatite (HA) coatings to total knee implants, especially with the tibial component, where failure of the implant more often occurs. A systematic review of the literature was undertaken to identify all prospective randomized trials for determining whether the overall clinical results (as a function of durability, function, and adverse events) favored HA-coated tibial components.MethodsA comprehensive literature search was performed for the years 1990 to September 16, 2010. We restricted our search to randomized controlled trials involving participants receiving either an HA-coated tibia or other forms of tibial fixation. The primary outcome measures evaluated were durability, function, and acute adverse events.ResultsData from 926 evaluable primary total knee implants in 14 studies were analyzed. Using an RSA definition for durability, HA-coated tibial components (porous or press-fit) without screw fixation were less likely to be unstable at 2 years than porous and cemented metal-backed tibial components (RR = 0.58, 95% CI: 0.34–0.98; p = 0.04, I2 = 39%, M-H random effects model). There was no significant difference in durability, as measured from revision and evaluated at 2 and 8–10 years, between groups. Also, functional status using different validated measures showed no significant difference at 2 and 5 years, no matter what measure was used. Lastly, there was no significant difference in adverse events. Limitations included small numbers of evaluable patients (≤ 50) in 7 of the 14 trials identified, and a lack of “hard” evidence of durability with need for replacement (i.e. frank failure, pain, or loss of functionality).InterpretationIn patients > 65 years of age, an HA-coated tibial implant may provide better durability than other forms of tibial fixation. Larger trials should be undertaken comparing the long-term durability, function, and adverse events of HA-coated implants with those of other porous-coated tibial implants in younger, more active OA patients.

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Section: Discussionmentioning

confidence: 75%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Hydroxyapatite (HA) coating appears to be of benefit for implant durability of tibial components in primary total knee arthroplasty

Voigt¹,

Mosier²

2011

Acta Orthopaedica

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“…They found that this design provides a predictably stable fixation, with excellent midterm clinical and radiological outcomes. A comparison between cemented, press-fit, and HAP-coated interfaces in Kinemax total knee replacement was carried out by Walker et al [9]. The indications are that uncemented tibial components need to be designed with a combination of posts or screws, which would reduce the interface micromotion to an insignificant level, together with accurate bone-cutting tools.…”

Section: Introductionmentioning

confidence: 99%

Functionally Graded Coating Material of Cementless Knee Prosthesis

Asiri

Fouda

Hedia

2016

BJAST

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Surfaces are the primary place of contact a biomaterial and its host organism. Surface treatment or coating provides a means to overcome the problem which appeared after knee replacement surgery. There are two main problems; the stress shielding and subsequent bone remodeling causes bone resorption around the implant especially at the proximal part of the knee under the tibia tray. The other problem is stem tip pain. Therefore, the aim of this investigation is to find a new design of coating material of a cementless total knee replacement using functionally graded material (FGM). The objective of this research is to find the optimal material compositions, as well as the optimal gradation direction. It is found that using both vertical and horizontal FGM coating increased the von Mises stress at the proximal part of the tibial cancellous bone. Von Mises stress in cancellous epiphyseal bone is increased by 77% using vertical and horizontal FGM coating

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Does the Method of Component Fixation Influence Clinical Outcomes After Total Knee Replacement? A Systematic Literature Review

Arnold¹,

Walters²,

Solomon³

et al. 2013

The Journal of Arthroplasty

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A comparison between cemented, press-fit, and HA-coated interfaces in Kinemax total knee replacement

Cited by 5 publications

References 15 publications

Hydroxyapatite (HA) coating appears to be of benefit for implant durability of tibial components in primary total knee arthroplasty

Hydroxyapatite (HA) coating appears to be of benefit for implant durability of tibial components in primary total knee arthroplasty

Functionally Graded Coating Material of Cementless Knee Prosthesis

Does the Method of Component Fixation Influence Clinical Outcomes After Total Knee Replacement? A Systematic Literature Review

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