Clinical results of alumina medial pivot total knee arthroplasty at a minimum follow-up of 10 years

Nakamura, Suguru; Minoda, Yukihide; Nakagawa, S.; Kadoya, Y.; Takemura, Susumu; Kobayashi, Akio; Mizokawa, Shigekazu; Ohta, Yoshiji; Takahashi, Sinji; Yamamura, Kazumasa; Nakamura, Hiroaki

doi:10.1016/j.knee.2016.12.011

Cited by 31 publications

(28 citation statements)

References 15 publications

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“…A recent report of TKA with a minimum follow-up of 10 years is shown in Table 4 [27][28][29][30][31][32][33][34][35]. The clinical outcomes described in these reports were comparable to the results of the present study.…”

Section: Discussionsupporting

confidence: 85%

Minimally invasive surgery total knee arthroplasty is less popular, but the prosthesis designed specifically for MIS provides good survival and PROMs with a minimum follow-up of 10 years

et al. 2021

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Background The concept of minimally invasive surgery (MIS) was introduced in total knee arthroplasty (TKA) in the late 1990s. The number of MIS TKAs has clearly decreased in recent years. An implant designed specifically for MIS TKA has been used all over the world, but there are no reports of long-term postoperative results. The purpose of this study was to characterize long-term clinical results with a minimum follow-up of 10 years. Methods This retrospective study included 109 consecutive patients with 143 NexGen CR-Flex prostheses, which are MIS tibial component prostheses designed specifically for MIS TKA. Twelve-year survival analysis was performed using Kaplan-Meier method. Revision surgery for any reason was the endpoint. Long-term clinical and radiographic results of 74 knees (55%) in 60 patients with more than 10 years of follow-up were analyzed. Results The cumulative survival rate of the single-radius posterior-stabilized TKA of 74 knees was 94.7% (95% confidence interval, 90–99%) at 12 years after surgery. Seven knees (9%) required additional surgery during the 10-year follow-up because of periprosthetic infections. Mean postoperative Knee Society knee score and functional score were 91 and 74 points, respectively. There were no cases of prosthesis breakage, polyethylene wear, or aseptic loosening of the prosthesis. Conclusion The prosthesis designed specifically for MIS TKA is associated with good survival and clinical results with a minimum follow-up of 10 years, even though MIS TKA has become less popular. Level of evidence III

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Section: Discussionsupporting

confidence: 85%

Minimally invasive surgery total knee arthroplasty is less popular, but the prosthesis designed specifically for MIS provides good survival and PROMs with a minimum follow-up of 10 years

et al. 2021

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“…Infections and instability accounted for 50% of the revisions (12 out of 24), while revisions due to fracture of the alumina femoral components and to wear of the UHMWPE insert took place only in 3 out of 24 cases. 38 Similar outcomes were reported by Nakamura et al, 39 who reviewed at a minimum follow-up of 10 years (range, 10–13), a cohort of 51 patients with 70 Medial Pivot Knee TKAs (Kyocera). These implants had an alumina femoral component and a titanium alloy tibial component hosting an EtO-sterilized UHMWPE insert.…”

Section: Literature Resultssupporting

confidence: 71%

Ceramic Total Knee Arthroplasty: Ready to Go?

Solarino

Piconi

Santis

et al. 2017

Joints

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Total knee arthroplasty (TKA) is a well-established surgical procedure in the late stages of knee osteoarthritis. Nevertheless, this procedure is associated with a percentage of unsatisfactory results and biomechanical failures, with aseptic loosening being the most common cause of revision. Beside these problems, cutaneous and systemic hypersensitivity reactions to metals have arisen as an increasing concern after joint arthroplasties, even if allergies against implant materials are still a quite rare and not well-known problem. Ceramic composites have been recently used in prosthetic components, showing minimum wear and excellent long-term results in total hip replacement, due to their high resistance to scratching and their better wettability with respect to cobalt–chromium alloy. Furthermore, the biologic response to debris generated from these bearings is less aggressive. Knee joint simulator tests and clinical results demonstrate promising results of TKAs with ceramic components that should led to benefit for the patients.

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“…31 Nakamura et al reported the survivorship of 70 Medial Pivot Knee replacements with an alumina femoral component (Kyocera Corporation, Kyoto, Japan) in patients with 10 to 13 years follow-up and found 99.1% cumulative survivorship at 10 years and good clinical outcomes. 32 Fitch et al reported a meta-analysis on the mid-and long-term outcomes of the Advance Medial Pivot and found 97.6% 8-year survivorship with excellent Knee Society scores (KSSs) on average. 33 Young et al performed a meta-analysis for studies comparing medially stabilized and nonmedially stabilized TKA, and reported mean KSS/Western Ontario and McMaster Universities Osteoarthritis Index score of 90/24 and 91/19 points for the medially stabilized and nonmedially stabilized cohorts, respectively, where both differences were statisti-cally significant, but without a clear clinical conclusion.…”

Section: Medially Constrained Designsmentioning

confidence: 99%

Rationale and Results for Fixed-Bearing Pivoting Designs in Total Knee Arthroplasty

Banks

Deckard

Hodge³

et al. 2019

J Knee Surg

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Total knee arthroplasty (TKA) is a maturing technology, and the focus for improvement centers on optimizing patient satisfaction and further reducing revisions. It is commonly assumed that achieving closer-to-normal knee mechanics in a TKA will result in further improvement in outcomes and revision rates. Fixed-bearing TKA designs with asymmetric pivoting articulations are designed to provide more natural joint stability and kinematics. These designs have been used for more than 20 years and there is a substantial body of literature characterizing their performance. This article reviews the various design types of fixed-bearing pivoting TKA designs, and recounts their clinical, functional, and patient-preference performance from peer-reviewed studies. To date, the evidence suggests there is measurable benefit to providing closer-to-normal joint stability and kinematics, and that fixed-bearing, pivoting TKA designs may decrease instability-related revisions and improve patient satisfaction.

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Clinical results of alumina medial pivot total knee arthroplasty at a minimum follow-up of 10 years

Cited by 31 publications

References 15 publications

Minimally invasive surgery total knee arthroplasty is less popular, but the prosthesis designed specifically for MIS provides good survival and PROMs with a minimum follow-up of 10 years

Minimally invasive surgery total knee arthroplasty is less popular, but the prosthesis designed specifically for MIS provides good survival and PROMs with a minimum follow-up of 10 years

Ceramic Total Knee Arthroplasty: Ready to Go?

Rationale and Results for Fixed-Bearing Pivoting Designs in Total Knee Arthroplasty

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