Five-Year Comparison of Oxidized Zirconium and Cobalt-Chromium Femoral Components in Total Knee Arthroplasty

Hui, Catherine; Salmon, Lucy J.; Maeno, Shinichi; Roe, Justin; Walsh, William R.; Pinczewski, Leo A.

doi:10.2106/jbjs.i.01753

Cited by 60 publications

(38 citation statements)

References 24 publications

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“…Because of their lack of a comparable sample with a different bearing type, no estimation of risk could be made. In the randomized controlled trial published by Hui et al (2011), which involved 40 patients and 80 knees (1 with CoCr and 1 with OZ femoral components), no differences in clinical, subjective, or radiographic outcomes were found 1, 2, and 5 years postoperatively. 2 patients (4 knees) were revised in this study during the follow-up (corresponding to a revision rate of 3% for each femoral component type) and no differences in wear pattern were reported in the retrieved components.…”

Section: Discussionmentioning

confidence: 92%

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Alternative bearings in total knee arthroplasty: risk of early revision compared to traditional bearings

Inacio¹,

Cafri²,

Paxton³

et al. 2013

Acta Orthopaedica

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Background and purpose There is no substantial clinical evidence for the superiority of alternative bearings in total knee arthroplasty (TKA). We compared the short-term revision risk in alternative surface bearing knees (oxidized zirconium (OZ) femoral implants or highly crosslinked polyethylene (HXLPE) inserts) with that for traditional bearings (cobalt-chromium (CoCR) on conventional polyethelene (CPE)). The risk of revision with commercially available HXLPE inserts was also evaluated.Methods All 62,177 primary TKA cases registered in a Total Joint Replacement Registry between April 2001 and December 2010 were retrospectively analyzed. The endpoints for the analysis were all-cause revisions, septic revisions, or aseptic revisions. Bearing surfaces were categorized as OZ-CPE, CoCr-HXLPE, or CoCr-CPE. HXLPE inserts were stratified according to brand name. Confounding was addressed using propensity score weights. Marginal Cox-regression models adjusting for surgeon clustering were used.Results The proportion of females was 62%. Average age was 68 (SD 9.3) years, and median follow-up time was 2.8 (IQR 1.2–4.9) years. After adjustments, the risks of all-cause, aseptic, and septic revision with CoCr-HXLPE and OZ-CPE bearings were not statistically significantly higher than with traditional CoCr-CPE bearings. No specific brand of HXLPE insert was associated with a higher risk of all-cause, aseptic, or septic revision compared to CoCr-CPE.Interpretation At least in the short term, none of the alternative knee bearings evaluated (CoCr-HXLPE or OZ-CPE) had a greater risk of all-cause, aseptic, and septic revision than traditional CoCr-CPE bearings.

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Section: Discussionmentioning

confidence: 92%

“…2 case series (Laskin 2003, Innocenti et al 2010) and 1 randomized control trial (Hui et al 2011) have been published evaluating the short- to medium-term survival of OZ femoral components. In the study by Innocenti et al (2010), younger, healthier, more active patients were selected to receive the OZ implants.…”

Section: Discussionmentioning

confidence: 99%

Alternative bearings in total knee arthroplasty: risk of early revision compared to traditional bearings

Inacio¹,

Cafri²,

Paxton³

et al. 2013

Acta Orthopaedica

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“…Similarly, a retrieval study revealed less surface damage on UHMWPE components that articulated against OxZr than components paired with CoCr [12]. Several series have compared OxZr TKA components with conventional bearing surfaces [14,17,18]; however, superiority of OxZr has not been demonstrated in terms of better implant survival, at least at midterm followup.…”

Section: Introductionmentioning

confidence: 99%

Oxidized Zirconium versus Cobalt-Chromium in TKA: Profilometry of Retrieved Femoral Components

Heyse

Elpers

Nawabi

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Analyses of synovial fluids and evaluation of amount and size of PE particles showed no differences between OxZr and CoCr femoral components [9,14].…”

Section: Discussionmentioning

confidence: 91%

Clinical Results of Oxidized Zirconium Femoral Component in TKA. A Review of Long-Term Survival

Civinini

Matassi

Carulli

et al. 2017

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Oxidized zirconium (OxZr) femoral component for total knee arthroplasty (TKA) have been introduced in an attempt to reduce polyethylene wear and secondary osteolysis and improve longevity of implants. Questions/Purposes: We reviewed clinical studies in literature evaluating OxZr femoral component for TKA. The aim of this review was to evaluate the clinical outcome and survival rate of TKA with an OxZr femoral component. Methods: A review of the existing literature was undertaken to collect data on the OxZr femoral component in order to provide a better understanding of its performance. Of 34 studies published in the literature, 8 met the eligibility criteria and were included in the final analysis. Results: Findings indicated that the mean Knee Society knee score improved in all series from preoperative to postoperative evaluation. The postoperative Knee Society knee score reported range from 84 to 95 and mean postoperative Knee Society functional score range from 74 to 90. The revision rate with this implant is low with up to 12.6 years of follow-up, with three revisions in total. The survival rate ranged from 100-98.7% at 5-7 years to 97.8% at 10 years. Conclusions: Excellent clinical outcome and high survival rate has been demonstrated for OxZr femoral component in TKA. No adverse reaction has been described for this new material.

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Five-Year Comparison of Oxidized Zirconium and Cobalt-Chromium Femoral Components in Total Knee Arthroplasty

Cited by 60 publications

References 24 publications

Alternative bearings in total knee arthroplasty: risk of early revision compared to traditional bearings

Alternative bearings in total knee arthroplasty: risk of early revision compared to traditional bearings

Oxidized Zirconium versus Cobalt-Chromium in TKA: Profilometry of Retrieved Femoral Components

Clinical Results of Oxidized Zirconium Femoral Component in TKA. A Review of Long-Term Survival

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