Better functional outcome after single-radius TKA compared with multi-radius TKA

Collados-Maestre, Isabel; Lizaur-Utrilla, Alejandro; Gonzalez-Navarro, Blanca; Miralles‐Muñoz, Francisco A.; Marco-Gomez, Luis; Lopez‐Prats, Fernando A.; Gil-Guillén, Vicente

doi:10.1007/s00167-016-4273-0

Cited by 20 publications

(40 citation statements)

References 24 publications

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“…Though the current study lacks a multi-radius control group, single and multi-radius TKAs have been compared previously. Randomised control trials comparing the Triathlon single-radius TKA with multi-radius TKAs have found in favour of the single-radius design [9, 20, 22]. Hamilton et al [22] reported significantly greater range of motion, more rapid recovery to 116% of quadriceps function compared to the contralateral side, greater satisfaction and reduced ‘worst daily pain’ following Triathlon ( n = 104) compared to a multi-radius TKA ( n = 108) over the 3 years of follow-up [22].…”

Section: Discussionmentioning

confidence: 99%

“…Hamilton et al [22] reported significantly greater range of motion, more rapid recovery to 116% of quadriceps function compared to the contralateral side, greater satisfaction and reduced ‘worst daily pain’ following Triathlon ( n = 104) compared to a multi-radius TKA ( n = 108) over the 3 years of follow-up [22]. Collados-Maestre et al [9] found significantly better knee society scores, WOMAC pain scores, range of motion and quadriceps strength in the single-radius group when comparing 118 single-radius and 119 multi-radius TKA designs at 5–7 years [9]. Biomechanical studies comparing single and multi-radius TKAs have found larger amounts of axial rotation in single-radius knees using dynamic fluoroscopy [19] and better power absorption during weight acceptance in single-radius TKAs at gait analysis [19].…”

Section: Discussionmentioning

confidence: 99%

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Excellent 10-year patient-reported outcomes and survival in a single-radius, cruciate-retaining total knee arthroplasty

Scott

Bell

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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PurposeOver 2 million Triathlon single-radius total knee arthroplasties (TKAs) have been implanted worldwide. This study reports the 10-year survival and patient-reported outcome of the Triathlon TKA in a single independent centre.MethodsFrom 2006 to 2007, 462 consecutive cruciate-retaining Triathlon TKAs were implanted in 426 patients (median age 69 (21–89), 289 (62.5%) female). Patellae were not routinely resurfaced. Patient-reported outcome measures (SF-12, Oxford Knee Scores (OKS), satisfaction) were assessed preoperatively and at 1, 5 and 10 years when radiographs were reviewed. Forgotten Joint Scores (FJS) were collected at 10 years. Kaplan–Meier survival analysis was performed.ResultsAt 10–11.6 years, 123 patients (128 TKAs) had died and 8 TKAs were lost to follow-up. There were four aseptic failures (two cases of tibial loosening, two cases of instability) and four septic failures requiring revision. Symptomatic aseptic radiographic loosening was present in three further cases at 11 years. Four (1%) patellae were secondarily resurfaced. OKS score improved by 17.7 ± 9.7 points at 1 year (p < 0.001), and was maintained at 34.7 ± 9.6 at 10 years with FJS 48.5 ± 31.4. Patient satisfaction was 88% at each timepoint. Ten-year survival was 97.9% (95% confidence interval 96.5–99.3) for revision for any reason, 98.9% (97.7–100) for mechanical failure, and 98.6% (97.4–99.8) for aseptic loosening (symptomatic radiographic or revised).ConclusionThe Triathlon TKA continues to show excellent longer-term results with high implant survivorship, low rates of aseptic failure, consistently maintained PROMs and excellent patient satisfaction rates of 88% at 10 years.Level of evidenceII, Prospective cohort study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Excellent 10-year patient-reported outcomes and survival in a single-radius, cruciate-retaining total knee arthroplasty

Scott

Bell

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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“…Palmer et al [22] compared 388 cases of SR and 674 cases of MR, and they found a significantly better flexion and KSSs in the SR group upon either 1-or 2-year follow-up than in the MR group, and 66.3% of their patients didn't experience any pain after 2 years against 54.4% of the patients with MR knees. Collados-Maestre et al [18] conducted the largest-sized RCT comparing the clinical outcomes and reported significant better KSSs, ROM, extension lag, quadriceps strength, chair test, and WOMAC pain and a higher satisfaction rate in the SR group. In our study, there were no significant differences in KSS-knee, function score and all the aspects of KOOS score, which is coincident with the previously reported findings [15,18,22].…”

Section: Discussionmentioning

confidence: 99%

“…In a cadaveric study, the SR knee required 57% less quadriceps force as compared to the MR knee, and the author inferred that SR design could reserve the strength of the extensor mechanism substantially [24]. Collados-Maestre et al [18] reported that the SR group showed a significantly better quadriceps strength than the MR group. Mahoney et al [8] found that 90% of the patients in the SR group, which was significantly higher than the proportion in the MR group, could rise from a folded chair independently at 2 years.…”

Section: Discussionmentioning

confidence: 99%

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Better quadriceps and hamstring strength is achieved after Total knee Arthroplasty with single radius femoral prostheses: a retrospective study based on isokinetic and isometric data

Zhang

et al. 2020

Arthroplasty

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Background: Strength deficits, muscle imbalances, and quadriceps inhibition are common after the total knee arthroplasty (TKA). It was suggested that theoretically single radius (SR) femoral protheses could provide longer extensor moment arm compared to the multiple radius (MR) design. However, quantitative evidence has not yet been reported. Thus, the aim of the study was to investigate the differences in isokinetic data and to compare the patient-reported outcome scores between TKA SR and MR design. Method: The present retrospective study included 36 TKA involving 16 knees (9 patients) using SR design implant and 20 knees (11 patients) using MR design implant. The mean follow-up time was longer than 1 year. Isokinetic knee flexion and extension torques of the operated leg were evaluated at 60°/s and 180°/s. Quadriceps and hamstring torques and ratios, work and power were recorded. Angle-specific torques were also collected at different extension or flexion angles. Results: Both groups showed improvement in knee society scores (KSS) and knee injury, and osteoarthritis outcome score (KOOS) after operation. Patients in SR group had significantly higher scores in KSS-knee, symptoms and activities of daily living KOOS sub-score than those in the MR group at the end of the follow-up. The peak knee flexion torque, peak knee extension torque and maximum knee flexion work were greater in SR group at 180°/s and 60°/s. At 60°/s, and SR group had higher average knee flexion power and average knee extension power than MR group. In the isometric contraction test, the knee extension torque was higher in SR group than in MR group. At 180°/s, SR group showed higher flexion torques at 30°, 40°, 50°, 60°compared with MR group. At 60°/s, SR group showed higher flexion torques at 30°, 40°, 50°, 60°, 80°when compared with MR group. Additionally, SR group also provided higher extension torques at 40°, 50°, 60°than the MR group. There were no differences in other isokinetic and isometric parameters between the two groups. Conclusion: Femoral design exerted an influence on quadriceps and hamstring strength after TKA, and SR design shows advantages, in terms of higher extension and flexion strength, over MR design.

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Valgus position of the femoral component causes abnormal kinematics in the presence of medial looseness in total knee arthroplasty: a computer simulation model of TKA for valgus knee osteoarthritis

Nishitani

Kuriyama

Nakamura

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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Purpose Total knee arthroplasty (TKA) for valgus knee osteoarthritis is challenging. Although overcorrection in TKA for valgus knee osteoarthritis is recommended, supportive data based on biomechanics have rarely been reported. The purpose of this study was to elucidate whether coronal rotation of the femoral compartment causes abnormal kinematics with or without medial looseness. Methods Multi‐ and single‐radius posterior‐stabilised TKA implants were utilised in a computer simulation. A total of 4 mm of slack were provided in the medial collateral ligament (MCL) with varus or valgus position of the femoral component to simulate the context of valgus knee osteoarthritis. Kinematics during gait and squatting activities were evaluated in each condition. Results During squatting, medial looseness and valgus replacement caused anterior translation of the medial femoral component in mid‐flexion in the multi‐radius implant. In the worst condition (7° valgus replacement with MCL looseness), there was rapid anterior translation in the multi‐radius implant, and moderate anterior translation in the single‐radius implant. Although medial looseness alone did not cause abnormal kinematics during gait, the worst condition exhibited an anterior translation to 4.9 mm in the multi‐radius implant. This worst condition also exhibited a marked lift‐off of 8.0 and 2.9 mm in the multi‐ and single‐radius implants, respectively. Varus position caused little abnormal kinematics even with MCL looseness. Conclusion Valgus, not varus position of the femoral component caused abnormal kinematics with MCL looseness. To avoid valgus position, the safety target angle of femoral component would be slight varus rather than neutral in valgus knee OA.

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Better functional outcome after single-radius TKA compared with multi-radius TKA

Abstract: Therapeutic study, Level I.

Cited by 20 publications

References 24 publications

Excellent 10-year patient-reported outcomes and survival in a single-radius, cruciate-retaining total knee arthroplasty

Excellent 10-year patient-reported outcomes and survival in a single-radius, cruciate-retaining total knee arthroplasty

Better quadriceps and hamstring strength is achieved after Total knee Arthroplasty with single radius femoral prostheses: a retrospective study based on isokinetic and isometric data

Valgus position of the femoral component causes abnormal kinematics in the presence of medial looseness in total knee arthroplasty: a computer simulation model of TKA for valgus knee osteoarthritis

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