Cost Effectiveness and Economic Impact of the KineSpring® Knee Implant System in the Treatment of Knee Osteoarthritis in Spain

Strain, Dan; Li, Chuan Silvia; Phillips, Mark; Piqueras, Olga Monteagudo; Bhandari, Mohit

doi:10.1615/jlongtermeffmedimplants.2015012728

Cited by 4 publications

(2 citation statements)

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“…Of 1289 studies eligible for inclusion in the abstract screen, 1201 were excluded for not meeting the inclusion criteria and repetition. After full text review, a further 28 studies were excluded,32 34 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 and 60 were included in the final analysis (fig 1).…”

Section: Resultsmentioning

confidence: 99%

Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis

Wilson

Middleton

Abram

et al. 2019

BMJ

233

206

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Objective To present a clear and comprehensive summary of the published data on unicompartmental knee replacement (UKA) or total knee replacement (TKA), comparing domains of outcome that have been shown to be important to patients and clinicians to allow informed decision making. Design Systematic review using data from randomised controlled trials, nationwide databases or joint registries, and large cohort studies. Data sources Medline, Embase, Cochrane Controlled Register of Trials (CENTRAL), and Clinical Trials.gov, searched between 1 January 1997 and 31 December 2018. Eligibility criteria for selecting studies Studies published in the past 20 years, comparing outcomes of primary UKA with TKA in adult patients. Studies were excluded if they involved fewer than 50 participants, or if translation into English was not available. Results 60 eligible studies were separated into three methodological groups: seven publications from six randomised controlled trials, 17 national joint registries and national database studies, and 36 cohort studies. Results for each domain of outcome varied depending on the level of data, and findings were not always significant. Analysis of the three groups of studies showed significantly shorter hospital stays after UKA than after TKA (−1.20 days (95% confidence interval −1.67 to −0.73), −1.43 (−1.53 to −1.33), and −1.73 (−2.30 to −1.16), respectively). There was no significant difference in pain, based on patient reported outcome measures (PROMs), but significantly better functional PROM scores for UKA than for TKA in both non-trial groups (standard mean difference −0.58 (−0.88 to −0.27) and −0.29 (−0.46 to −0.11), respectively). Regarding major complications, trials and cohort studies had non-significant results, but mortality after TKA was significantly higher in registry and large database studies (risk ratio 0.27 (0.16 to 0.45)), as were venous thromboembolic events (0.39 (0.27 to 0.57)) and major cardiac events (0.22 (0.06 to 0.86)). Early reoperation for any reason was higher after TKA than after UKA, but revision rates at five years remained higher for UKA in all three study groups (risk ratio 5.95 (1.29 to 27.59), 2.50 (1.77 to 3.54), and 3.13 (1.89 to 5.17), respectively). Conclusions TKA and UKA are both viable options for the treatment of isolated unicompartmental osteoarthritis. By directly comparing the two treatments, this study demonstrates better results for UKA in several outcome domains. However, the risk of revision surgery was lower for TKA. This information should be available to patients as part of the shared decision making process in choosing treatment options. Systematic review registration PROSPERO number CRD42018089972.

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Section: Resultsmentioning

confidence: 99%

Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis

Wilson

Middleton

Abram

et al. 2019

BMJ

233

206

View full text Add to dashboard Cite

show abstract

“…For younger active patients with knee OA, common treatments include non-invasive options, i.e., weight loss, exercise, braces, physical therapy as well as pharmacologic recourses such as analgesics and anti-inflammatories [ 1 ]. These can be used to manage symptoms before considering, as a last resort, the surgical options, which are mainly recommended for patients over the age of 65 [ 1 , 21 ]. General surgical options to treat knee osteoarthritis include Unicompartmental Knee Arthroplasty (UKA), High Tibial Osteotomy (HTO), and Total Knee Arthroplasty (TKA) as well as recently developed surgical interventions, such as the Atlas® system (Moximed, Inc.), which is a unicompartmental load-sharing implant [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Preliminary biomechanical cadaver study investigating a new load-sharing knee implant

et al. 2021

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Purpose One of the major contributors to the progression of knee osteoarthritis (OA) is the condition of loading in the knee joint. Innovatively designed load-sharing implants may be effective in terms of reducing joint load. The effects of these implants on contact joint mechanics can be evaluated through cadaver experiments. In this work, a case study is carried out with cadaver knee specimens to carry out a preliminary investigation into a novel load-sharing knee implant, in particular to study the surgical procedures required for attachment, and to determine the contact pressures in the joint with and without the implant. Methods Contact pressure in the tibiofemoral joint was measured using pressure mapping sensors, with and without the implant, and radiographs were conducted to investigate the influence of the implant on joint space. The implant was designed from a 3D model of the specimen reconstructed by segmenting MR images of the knee, and it was manufactured by CNC machining. Results It was observed that attachment of the implant does not affect the geometry of the hard/soft tissues. Radiographs showed that the implant led to an increase in the joint space on the medial side. Contact pressure measurements showed that the implant reduced the load on the medial side by approximately 18% under all tested loading conditions. By increasing the load from 800 to 1600 N, the percentage of load reduction in the lateral side was decreased by 8%. After applying 800, 1200, and 1600 N load it was observed that the peak contact pressures were 3.7, 4.6, and 5.5 MPa, respectively. Conclusions This new knee implant shows some promise as a treatment for OA, through its creation of a conducive loading environment in the knee joint, without sacrificing or damaging any of the hard or soft tissues. This device could be as effective as, for example, the Atlas® system, but without some complications seen with other devices; this would need to be validated through similar results being observed in an appropriate in vivo study.

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Modelling the cost-effectiveness of total knee arthroplasty: A systematic review

Kamaraj

Seah

et al. 2020

Journal of Orthopaedics

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Cost Effectiveness and Economic Impact of the KineSpring® Knee Implant System in the Treatment of Knee Osteoarthritis in Spain

Cited by 4 publications

References 0 publications

Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis

Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis

Preliminary biomechanical cadaver study investigating a new load-sharing knee implant

Modelling the cost-effectiveness of total knee arthroplasty: A systematic review

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