No difference in 13-year survival after medial pivot or central pivot mobile bearing total knee arthroplasty. A propensity matched comparative analysis

Jenny, Jean–Yves; Bercovy, Michel; Cazenave, A.; Gaillard, Thierry; Chatain, F.; Jolles, Brigitt E; Rouvillain, Jean-Louis; Saragaglia, D.; Surgery, Knee

doi:10.1007/s00167-020-06355-0

Cited by 3 publications

(10 citation statements)

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“… 44 Another article found no difference in survivorship at 13 years between MP and central mobile-bearing TKAs. 45 In a recent review article, Cacciola et al 46 found that primary MP implants in general provide overall mid-term survivorship comparable to standard cruciate-retaining and posterior-stabilized implants, according to the available data, and yield better high-end function than standard implants.…”

Section: Discussionmentioning

confidence: 99%

Early migration of a medially stabilized total knee arthroplasty

et al. 2021

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Aims Medial pivot (MP) total knee arthroplasties (TKAs) were designed to mimic native knee kinematics with their deep medial congruent fitting of the tibia to the femur almost like a ball-on-socket, and a flat lateral part. GMK Sphere is a novel MP implant. Our primary aim was to study the migration pattern of the tibial tray of this TKA. Methods A total of 31 patients were recruited to this single-group radiostereometric analysis (RSA) study and received a medial pivot GMK Sphere TKA. The distributions of male patients versus female patients and right versus left knees were 21:10 and 17:14, respectively. Mean BMI was 29 kg/m2 (95% confidence interval (CI) 27 to 30) and mean age at surgery was 63 years (95% CI 61 to 66). Maximum total point motions (MTPMs), medial, proximal, and anterior translations and transversal, internal, and varus rotations were calculated at three, 12, and 24 months. Patient-reported outcome measure data were also retrieved. Results MTPMs at three, 12, and 24 months were 1.0 mm (95% CI 0.8 to 1.2), 1.3 mm (95% CI 0.9 to 1.7), and 1.4 mm (0.8 to 2.0), respectively. The Forgotten Joint Score was 79 (95% CI 39 to 95) and Knee Injury and Osteoarthritis Outcome Score obtained at two years was 94 (95% CI 81 to 100), 86 (95% CI 75 to 93), 94 (95% CI 88 to 100), 69 (95% CI 48 to 88), and 81 (95% CI59 to 100) for Pain, Symptoms, Activities of Daily Living, Sport & Recreation, and Quality of Life, respectively. Conclusion In conclusion, we found that the mean increase in MTPM was lower than 0.2 mm between 12 and 24 months and thus apparently stable. Yet the GMK Sphere had higher migration at one and two years than anticipated. Based on current RSA data, we therefore cannot conclude on the long-term performance of the implant, pending further assessment. Cite this article: Bone Jt Open 2021;2(9):737–744.

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Section: Discussionmentioning

confidence: 99%

Early migration of a medially stabilized total knee arthroplasty

et al. 2021

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“…Seven of the nine studies included reported no reoperations or revisions due to aseptic loosening [21,22,[24][25][26][27]29]. Only two studies highlighted instances of revisions because of aseptic loosening, marking a prevalence rate of 0.4% [23,28]. Karachalios et al [23] and Jenny et al [28] registered a revision prevalence due to aseptic loosening of 1.2%, corresponding to 3 out of 251 and 4 out of 335 MP-TKAs, respectively.…”

Section: Causes Of Reoperationsmentioning

confidence: 99%

“…Initially, 667 records were identified through the database search. After removing duplicates and applying the inclusion and exclusion criteria, nine studies were ultimately selected for qualitative analysis [21][22][23][24][25][26][27][28][29] (Figure 1). resolution was sought via consultation with the senior author (GS).…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

“…The overall quality of the included studies was deemed "good", with an average MINORS score of 9.9 (ranging from 9 to 11). Except for one study that achieved an excellent score [29], all other studies were rated as "good" [21][22][23][24][25][26][27][28].…”

Section: Assessment Of Study Qualitymentioning

confidence: 99%

“…The final analysis comprised nine studies [21][22][23][24][25][26][27][28][29], encompassing an initial cohort of 2009 MP-TKA procedures. After excluding patients who had died (196 knees, 9.8%) or were lost to follow-up (221 knees, 11%), 1592 patients were included in the final analysis.…”

Section: Demographics Survivorship and Reasons For Revisionmentioning

confidence: 99%

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Long-Term Follow-Up of Medial Pivot Total Knee Arthroplasty: A Systematic Review of the Current Evidence

et al. 2023

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Total knee arthroplasty (TKA) is a popular treatment for end-stage knee osteoarthritis. Advances in understanding knee biomechanics have led to the development of medial pivot (MP) prostheses, which aim to replicate natural knee kinematics. While short- and mid-term studies have shown favorable outcomes for MP-TKA, long-term follow-up studies are limited. This systematic review aims to analyze the available evidence on long-term outcomes of MP-TKA, including survivorship, complications, and patient-reported outcome measures (PROMs). A comprehensive search was conducted in PubMed, Embase, and Cochrane Database of Systematic Reviews for English language studies reporting long-term outcomes of primary MP-TKA. Nine studies with an average follow-up of 12.4 years were included. Data on survivorship, complications, and PROMs were collected and analyzed. The overall survivorship of MP-TKA was 98.2% at an average follow-up of 12.4 years. Aseptic loosening and periprosthetic joint infection (PJI) were the most common reasons for revision, with a revision rate of 0.4% for each. The overall complication rate was 6.6%, with secondary anterior knee pain and PJI being the most frequent complications. The reoperation rate was 3.1%, primarily due to PJI and knee instability. PROMs significantly improved postoperatively. MP-TKA demonstrates favorable long-term outcomes with high survivorship, low complication rates, and enhanced PROMs. The procedure provides reliable management for end-stage osteoarthritis, offering patients improved knee function and pain relief. Further research with standardized reporting and larger sample sizes is needed to validate and compare these findings to other implant designs.

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Efficiency assessment of follow-up methodology of patients with knee replacement to predict post-surgical functionality: a protocol for randomised control PROKnee trial

San Martín Valenzuela,

Tabarés-Seisdedos,

Payá Rubio

et al. 2024

BMJ Open

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IntroductionEven when total knee arthroplasty (TKA) is an extended treatment, most patients experience a suboptimal evolution after TKA. The objectives of this study are the following: (1) to determine the effectiveness of two different prosthesis stabilisation systems on the functionality in activities of daily life, and (2) to determine prognostic biomarkers of knee prosthesis function based on radiological information, quantification of cytokines, intra-articular markers and biomechanical functional evaluation to predict successful evolution.Methods and analysisThe PROKnee trial was designed as a randomised controlled patient-blinded trial with two parallel groups that are currently ongoing. The initial recruitment will be 99 patients scheduled for their first TKA, without previous prosthesis interventions in lower limbs, who will be randomly divided into two groups that differed in the stabilisation methodology incorporated in the knee prosthesis: the MEDIAL-pivot group and the CENTRAL-pivot group. The maximum walking speed will be reported as the primary outcome, and the secondary results will be patient-reported questionnaires related to physical status, cognitive and mental state, radiological test, laboratory analysis and biomechanical instrumented functional performance, such as the 6-minute walking test, timed up-and-go test, gait, sit-to-stand, step-over, and ability to step up and down stairs. All the results will be measured 1 week before TKA and at 1.5, 3, 6 and 12 months after surgery.Ethics and disseminationAll procedures were approved by the Ethical Committee for Research with Medicines of the University Clinical Hospital of Valencia on 8 October 2020 (order no. 2020/181). Participants are required to provide informed consent for the study and for the surgical procedure. All the data collected will be treated confidentially since they will be blinded and encrypted. The results from the trial will be published in international peer-reviewed scientific journals, regardless of whether these results are negative or inconclusive.Trial registration numberClinicalTrials.gov Registry (NCT04850300).

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No difference in 13-year survival after medial pivot or central pivot mobile bearing total knee arthroplasty. A propensity matched comparative analysis

Cited by 3 publications

References 36 publications

Early migration of a medially stabilized total knee arthroplasty

Early migration of a medially stabilized total knee arthroplasty

Long-Term Follow-Up of Medial Pivot Total Knee Arthroplasty: A Systematic Review of the Current Evidence

Efficiency assessment of follow-up methodology of patients with knee replacement to predict post-surgical functionality: a protocol for randomised control PROKnee trial

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