A randomised RSA study of Peri-Apatite™ HA coating of a total knee prosthesis

Hansson, Ulrik; Ryd, Leif; Toksvig‐Larsen, Sören

doi:10.1016/j.knee.2008.01.013

Cited by 38 publications

(23 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Evaluation of performance against the RSA (MPTM) endpoint was done at 2 years (Regnér et al 1998, Nilsson et al 1999, 2006, Toksvig-Larsen et al 2000, Carlsson et al 2005, Hansson et al 2008, Pijls et al 2010)…”

Section: Resultsmentioning

confidence: 99%

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

Voigt¹,

Mosier²

2011

Acta Orthopaedica

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

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

Voigt¹,

Mosier²

2011

Acta Orthopaedica

View full text Add to dashboard Cite

show abstract

“…2 Using these same RSA criteria, a high proportion of ‘at risk’ components have also been reported for cementless TKRs using the Duracon prosthesis. Hansson et al 13 reported that 56% of porous-coated components had continuous migration (according to the classification of Ryd et al 26 ), while 33% of hydroxyapatite-coated components had continuous migration, whereas registry data reports a cumulative revision rate for Duracon with cemented fixation of only 4.2% at ten years. 3 Furthermore, while the proportion of Triathlon components classified as being ‘at risk’ in the present study was lower (17%) than for Duracon, based on a cumulative revision rate of 2.5% at five years given by the Australian registry, 2 this is also considerably higher than should be expected.…”

Section: Discussionmentioning

confidence: 99%

Does a new knee design perform as well as the design it replaces?

Molt

Ljung

2012

Bone & Joint Research

View full text Add to dashboard Cite

ObjectivesThe objective of this study was to compare the early migration characteristics and functional outcome of the Triathlon cemented knee prosthesis with its predecessor, the Duracon cemented knee prosthesis (both Stryker).MethodsA total 60 patients were prospectively randomised and tibial component migration was measured by radiostereometric analysis (RSA) at three months, one year and two years; clinical outcome was measured by the American Knee Society score and the Knee Osteoarthritis and Injury Outcome Score.ResultsThere were no statistically significant differences in rotation or translation around or along the three coordinal axes, or in the maximum total point motion (MTPM) during the two-year follow-up.ConclusionsThe Triathlon cemented knee prosthesis has similar early stability and is likely to perform at least as well as the Duracon cemented knee prosthesis over the longer term.

show abstract

“…3 Forest plot assessing reoperation following total knee arthroplasty or sometimes even higher than, their metal-backed counterparts. RSA, which is an accurate instrument to measure in vivo implant migration, is considered indispensable in a controlled introduction of new implant technology [19,20,28]. Long-term follow-up studies show a correlation between early implant migration and later aseptic loosening [19,53].…”

Section: Discussionmentioning

confidence: 99%