International Comparative Evaluation of Knee Replacement with Fixed or Mobile Non-Posterior-Stabilized Implants
| العنوان: | International Comparative Evaluation of Knee Replacement with Fixed or Mobile Non-Posterior-Stabilized Implants |
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| المؤلفون: | Stephen E. Graves, Art Sedrakyan, Guy Cafri, Susanna Stea, Elizabeth W. Paxton, Lluis Puig-Verdié, Robert S. Namba, Ove Furnes, Otto Robertsson, Daniel Hoeffel |
| المصدر: | Journal of Bone and Joint Surgery. 96:52-58 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2014. |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Adult, Male, Scientific Articles, medicine.medical_specialty, Knee Joint, medicine.medical_treatment, Knee replacement, Prosthesis Design, Humans, Medicine, Orthopedics and Sports Medicine, Registries, Range of Motion, Articular, Arthroplasty, Replacement, Knee, Aged, Aged, 80 and over, business.industry, Hazard ratio, General Medicine, Middle Aged, Osteoarthritis, Knee, Arthroplasty, Surgery, medicine.anatomical_structure, Posterior cruciate ligament, Orthopedic surgery, Female, Implant, Knee Prosthesis, business, Range of motion |
| الوصف: | Background: Mobile-bearing total knee prostheses were designed to reduce wear and improve implant survivorship following total knee arthroplasty. However, the benefit of mobile-bearing total knee arthroplasty remains unproven. Both mobile-bearing and fixed-bearing total knee arthroplasty implants are available in posterior-stabilized and non-posteriorstabilized designs. With the latter, the implant does not recreate the function of the posterior cruciate ligament (PCL) with a posterior-stabilizing cam mechanism. The purpose of the present study was to compare mobile-bearing, non-posteriorstabilized devices with fixed-bearing, non-posterior-stabilized devices used in total knee arthroplasty through a novel multinational study design. Methods: Through the use of a distributed health data network, primary total knee arthroplasties performed for osteoarthritis from 2001 to 2010 were identified from six national and regional total joint arthroplasty registries. Multivariate meta-analysis was performed with use of linear mixed models, with the primary outcome of interest being revision for any reason. Survival probabilities and their standard errors were extracted from each registry for each unique combination of the covariates. Results: A total of 319,616 patients (60% female) underwent non-posterior-stabilized total knee arthroplasty. A fixedbearing, non-posterior-stabilized design was used in 258,190 (81%) of the knees and a mobile-bearing, non-posteriorstabilized design in 61,426 (19%) of the knees. Sixty-nine percent of the patients who received a fixed-bearing implant were over sixty-five years of age, compared with 63% of those who received a mobile-bearing implant. Mobile-bearing designs had a higher risk of revision, with a hazard ratio of 1.43 (95% confidence interval, 1.36 to 1.51; p < 0.001). Conclusions: Previous comparisons of mobile-bearing and fixed-bearing total knee arthroplasty outcomes have been inconclusive. The current study utilized an advanced, harmonized distributed analysis of six national and regional jointreplacement registries. To our knowledge, it is the largest analysis of mobile-bearing total knee arthroplasty to date. Mobile-bearing, non-posterior-stabilized designs presented a greater risk of failure than was found for fixed-bearing, nonposterior-stabilized designs. Caution should be used in the selection of the mobile-bearing non-posterior-stabilized design for total knee replacement. |
| تدمد: | 1535-1386 0021-9355 |
| DOI: | 10.2106/jbjs.n.00466 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::87258d02df8be8e29e813d6d3c794697 https://doi.org/10.2106/jbjs.n.00466 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....87258d02df8be8e29e813d6d3c794697 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15351386 00219355 |
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| DOI: | 10.2106/jbjs.n.00466 |