Mid-term survivorship of primary total knee arthroplasty with a specific implant

Abstract

AimsThe purpose of this study was to assess mid-term survivorship following primary total knee arthroplasty (TKA) with Optetrak Logic components and identify the most common revision indications at a single institution.MethodsWe identified a retrospective cohort of 7,941 Optetrak primary TKAs performed from January 2010 to December 2018. We reviewed the intraoperative findings of 369 TKAs that required revision TKA from January 2010 to December 2021 and the details of the revision implants used. Kaplan-Meier analysis was used to determine survivorship. Cox regression analysis was used to examine the impact of patient variables and year of implantation on survival time.ResultsThe estimated survivorship free of all-cause revision was 98% (95% confidence interval (CI) 97% to 98%), 95% (95% CI 95% to 96%), and 86% (95% CI 83% to 88%) at two, five, and ten years, respectively. In 209/369 revisions there was a consistent constellation of findings with varying severity that included polyethylene wear and associated synovitis, osteolysis, and component loosening. This failure mode, which we refer to as aseptic mechanical failure, was the most common revision indication. The mean time from primary TKA to revision for aseptic mechanical failure was five years (5 months to 11 years).ConclusionIn this series of nearly 8,000 primary TKAs performed with a specific implant, we identified a lower-than-expected mid-term survivorship and a high number of revisions with a unique presentation. This study, along with the recent recall of the implant, confirms the need for frequent monitoring of patients with Optetrak TKAs given the incidence of polyethylene failure, osteolysis, and component loosening.Cite this article: Bone Joint J 2023;105-B(3):277–283.

Short-Term Outcomes of Total Knee Arthroplasty Using a Conventional, Computer-Assisted, and Robotic Technique: A Pilot Clinical Trial

“…It aims to contribute to the prosthetic knee’s long-term survivorship by minimizing wear and potential failures, thereby enhancing overall patient quality of life. In particular, it has been previously shown that RA-TKA results in better precision in achieving planned limb alignment and implant positioning than conventional methods [ 27 ]. This precision aims to improve functional outcomes for patients through more physiological joint stability and mobility.…”

“…A notable limitation of this study is its reliance on short-term follow-up data to formulate conclusions. It is important to recognize that, according to current research, manually implanted TKA demonstrated long-term survivorship (spanning ten to fifteen years) exceeding 90%, particularly when prosthetic failure is attributed to loosening [ 27 , 28 , 29 ]. These studies indicate a commencement of decline in prosthesis survivorship within the short-term follow-up period (3–5 years post-surgery).…”