Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements
Yıl: 2019 Cilt: 30 Sayı: 2 Sayfa Aralığı: 70 - 78 Metin Dili: İngilizce DOI: 10.5606/ehc.2019.62830 İndeks Tarihi: 25-11-2019
Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements
Öz: Objectives: This study aims to determine whether there is a difference in the rate of survival and risk of revision for mobilebearing (MB) compared with fixed-bearing (FB) total knee replacements (TKRs). Patients and methods: This prospective observational study included 1,571 cemented non-posterior-stabilized TKRs without patellar resurfacing with the subsequent revision surgery in 63 patients (23 males, 40 females; mean age 69.7 years; range, 46.5 to 85.5 years). The group of FB TKRs consisted of 756 non-revised and 31 revised implants. The group of MB TKRs included 752 non-revised and 32 revised knees. We determined the survival rate of TKR with Kaplan-Meier method and the relative risk (RR) of the revision in relation to the type of the insert. The analysis of the RR was divided into subgroups based on the time to revision and the reason for revision. Results: No significant difference was found between FB and MB TKRs regarding the cumulative survival rate and the RR of total revision for any reasons. In the subgroup of early revisions for any reason, 2.22-fold increased risk of revision was found in the MB (p=0.02). The risk of late revisions for any reason in MB was lower than the risk in FB (RR 0.27; p=0.009). Higher risk of revision for instability was found in the subgroup of early revisions in MB (RR 23.8; p=0.03). MB was associated with significantly lower risk of total (RR 0.46; p=0.049) and late revisions for aseptic loosening (RR 0.14; p=0.008). Conclusion: No differences were found in the cumulative survival rates between MB and FB TKRs. MB TKRs were associated with a lower risk of revision due to aseptic loosening in comparison with FB TKRs. MB inserts represented a significant risk factor only for early revisions due to instability.
Anahtar Kelime: Konular:
Hareketli polietilen ve sabit polietilen total diz replasmanları için sağkalım oranı ve revizyon riskinin karşılaştırılması
Öz: Amaç: Bu çalışmada hareketli polietilen (HP)’e kıyasla sabit polietilen (SP) total diz replasmanı (TDR)’nda sağkalım oranı ve revizyon riskinde farklılık olup olmadığı belirlendi. Hastalar ve yöntemler: Bu prospektif gözlemsel çalışmaya 63 hastada (23 erkek, 40 kadın; ort. yaş 69.7 yıl; dağılım, 46.5-85.5 yıl) takip eden revizyon cerrahisi olan, patella eklem yüzeyi değiştirilmeyen 1571 çimentolu posterior olmayan stabilize TDR dahil edildi. SP TDR grubu 756 revize olmayan ve 31 revize implanttan oluştu. HP TDR grubu 752 revize olmayan ve 32 revize diz içerdi. TDR’nin sağkalım oranı Kaplan-Meier yöntemi ile belirlendi ve revizyonun insert tipine ilişkin göreli risk (GR)’i belirlendi. Göreli riskin analizi revizyon zamanı ve revizyon nedenine dayanılarak alt gruplara ayrıldı. Bulgular: Sabit polietilen ve HP TDR’ler arasında kümülatif sağkalım oranı ve herhangi bir nedenle total revizyonun GR’si açısından anlamlı farklılık bulunmadı. Herhangi bir nedenle erken revizyon alt grubunda, HP’de 2.22 kat artmış revizyon riski bulundu (p=0.02). HP’de herhangi bir nedenle geç revizyon riski SP’deki riskten daha düşüktü (GR 0.27; p=0.009). HP’de erken revizyon alt grubunda instabilite için daha yüksek revizyon riski bulundu (GR 23.8; p=0.03). HP aseptik gevşeme için anlamlı şekilde daha düşük total (GR 0.46; p=0.049) ve geç (GR 0.14; p=0.008) revizyon riski ile ilişkiliydi. Sonuç: Hareketli polietilen ve SP TDR’ler arasında kümülatif sağkalım oranlarında farklılık bulunmadı. SP TDR’lere kıyasla HP TDR’ler aseptik gevşemeye bağlı daha düşük revizyon riski ile ilişkiliydi. HP insertler sadece instabiliteye bağlı erken revizyonlar için anlamlı bir risk faktörü oluşturdu.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- Gothesen O, Lygre SHL, Lorimer M, Graves S, Furnes O. Increased risk of aseptic loosening for 43,525 rotatingplatform vs. fixed-bearing total knee replacements. Acta Orthop 2017;88:649-56.
- Graves S, Sedrakyan A, Baste V, Gioe TJ, Namba R, Martínez Cruz O, et al. International comparative evaluation of knee replacement with fixed or mobile-bearing posteriorstabilized prostheses. J Bone Joint Surg Am 2014;96:59-64.
- Namba R, Graves S, Robertsson O, Furnes O, Stea S, PuigVerdié L, et al. International comparative evaluation of knee replacement with fixed or mobile non-posterior-stabilized implants. J Bone Joint Surg Am 2014;96:52-8.
- Khan M, Osman K, Green G, Haddad FS. The epidemiology of failure in total knee arthroplasty: avoiding your next revision. Bone Joint J 2016;98:105-12.
- Capella M, Dolfin M, Saccia F. Mobile bearing and fixed bearing total knee arthroplasty. Ann Transl Med 2016;4:127.
- Wyatt MC, Frampton C, Horne JG, Devane P. Mobile- versus fixed-bearing modern total knee replacements- which is the more patella-friendly design?: The 11-year New Zealand Joint Registry study. Bone Joint Res 2013;2:129-31.
- O’Connor JJ, Goodfellow JW. Theory and practice of meniscal knee replacement: designing against wear. Proc Inst Mech Eng H 1996;210:217-22.
- Callaghan JJ, Insall JN, Greenwald AS, Dennis DA, Komistek RD, Murray DW, et al. Mobile-bearing knee replacement: concepts and results. Instr Course Lect 2001;50:431-49.
- Gøthesen O, Espehaug B, Havelin L, Petursson G, Lygre S, Ellison P, et al. Survival rates and causes of revision in cemented primary total knee replacement: a report from the Norwegian Arthroplasty Register 1994-2009. Bone Joint J 2013;95:636-42.
- Kutzner I, Hallan G, Høl PJ, Furnes O, Gøthesen Ø, Figved W, et al. Early aseptic loosening of a mobile-bearing total knee replacement. Acta Orthop 2018;89:77-83.
- Namba RS, Inacio MC, Paxton EW, Ake CF, Wang C, Gross TP, et al. Risk of revision for fixed versus mobile-bearing primary total knee replacements. J Bone Joint Surg [Am] 2012;94:1929-35.
- Paxton EW, Furnes O, Namba RS, Inacio MC, Fenstad AM, Havelin LI. Comparison of the Norwegian knee arthroplasty register and a United States arthroplasty registry. J Bone Joint Surg [Am] 2011;93:20-30.
- Bo ZD, Liao L, Zhao JM, Wei QJ, Ding XF, Yang B. Mobile bearing or fixed bearing? A meta-analysis of outcomes comparing mobile bearing and fixed bearing bilateral total knee replacements. Knee 2014;21:374-81.
- Jasper LL, Jones CA, Mollins J, Pohar SL, Beaupre LA. Risk factors for revision of total knee arthroplasty: a scoping review. BMC Musculoskelet Disord 2016;17:182.
- Moskal JT, Capps SG. Rotating-platform TKA no different from fixed-bearing TKA regarding survivorship or performance: a meta-analysis. Clin Orthop Relat Res 2014;472:2185-93.
- Fransen BL, van Duijvenbode DC, Hoozemans MJM, Burger BJ. No differences between fixed- and mobile-bearing total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2017;25:1757-77.
| APA | LACKO M, SCHREİEROVA D (2019). Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements. , 70 - 78. 10.5606/ehc.2019.62830 |
| Chicago | LACKO Marek,SCHREİEROVA Daniela Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements. (2019): 70 - 78. 10.5606/ehc.2019.62830 |
| MLA | LACKO Marek,SCHREİEROVA Daniela Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements. , 2019, ss.70 - 78. 10.5606/ehc.2019.62830 |
| AMA | LACKO M,SCHREİEROVA D Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements. . 2019; 70 - 78. 10.5606/ehc.2019.62830 |
| Vancouver | LACKO M,SCHREİEROVA D Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements. . 2019; 70 - 78. 10.5606/ehc.2019.62830 |
| IEEE | LACKO M,SCHREİEROVA D "Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements." , ss.70 - 78, 2019. 10.5606/ehc.2019.62830 |
| ISNAD | LACKO, Marek - SCHREİEROVA, Daniela. "Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements". (2019), 70-78. https://doi.org/10.5606/ehc.2019.62830 |
| APA | LACKO M, SCHREİEROVA D (2019). Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), 30(2), 70 - 78. 10.5606/ehc.2019.62830 |
| Chicago | LACKO Marek,SCHREİEROVA Daniela Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) 30, no.2 (2019): 70 - 78. 10.5606/ehc.2019.62830 |
| MLA | LACKO Marek,SCHREİEROVA Daniela Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), vol.30, no.2, 2019, ss.70 - 78. 10.5606/ehc.2019.62830 |
| AMA | LACKO M,SCHREİEROVA D Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2019; 30(2): 70 - 78. 10.5606/ehc.2019.62830 |
| Vancouver | LACKO M,SCHREİEROVA D Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2019; 30(2): 70 - 78. 10.5606/ehc.2019.62830 |
| IEEE | LACKO M,SCHREİEROVA D "Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements." Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), 30, ss.70 - 78, 2019. 10.5606/ehc.2019.62830 |
| ISNAD | LACKO, Marek - SCHREİEROVA, Daniela. "Comparison of survival rate and risk of revision for mobile-bearing and fixed-bearing total knee replacements". Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) 30/2 (2019), 70-78. https://doi.org/10.5606/ehc.2019.62830 |
