Late stabilization after initial migration in patients undergoing cemented total knee arthroplasty: a 5-year followup of 2 randomized controlled trials using radiostereometric analysis
Acta Orthopaedica, vol. 93, pp. 271–276
Abstract
BACKGROUND AND PURPOSE: In total knee arthroplasty (TKA), metal-backed (MBT) and all-polyethylene (APT) designs have shown comparable implant migration up to 2 years postoperatively using radiostereometric analysis (RSA). However, studies comparing mid-term migration of both designs are lacking. Furthermore, continuously migrating TKAs up to 2 years may continue to migrate or stabilize thereafter. Therefore, we compared 5-year migration of MBT and APT using either cruciate-stabilizing (CS) or posteriorstabilizing (PS) designs and specifically assessed migration profiles of continuously migrating TKAs beyond 2 years. PATIENTS AND METHODS: The present study includes results from 2 randomized trials comparing migration of cemented MBT with APT of either CS (CS study, n = 59) or PS (PS study, n = 56) design. 2 surgeons performed all surgeries. We used a linear mixed model for the analyses. RESULTS: The overall migration between MBT and APT TKAs was similar for either the CS or PS design over a 5-year period. In both studies combined, 9 implants showed continuous migration in the second postoperative year, of which 1 (APT-CS) was revised for instability, 4 (2 MBT-CS, MBT-PS, APT-PS) stabilized, and 4 (2 MBT-CS, APT-CS, MBT-PS) lacked 5-year data. INTERPRETATION: Overall migration was similar between MBT and APT TKAs up to 5 years, for both the CS and PS design. 4 initially migrating TKAs stabilized between 2- and 5-year follow-up, stressing the need for longer-term followup to determine whether second-year continuous migration correctly predicts loosening.
Authors 6
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Leiden University Medical Center
Affiliation as printed
Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands. S.Hasan@lumc.nl
Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands. b.l.kaptein@lumc.nl
Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands. p.j.marang-van_de_mheen@lumc.nl
Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands. K.T.van_Hamersveld@lumc.nl
Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands. r.g.h.h.nelissen@lumc.nl
Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
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Lund University · Hässleholms Sjukhus
Affiliation as printed
Department of Orthopaedics, Hässleholm Hospital, Hässleholm, Sweden and Department of Clinical Sciences, Lund University, Lund, Sweden. soren.toksvig-larsen@med.lu.se
Department of Orthopaedics, Hässleholm Hospital, Hässleholm, Sweden and Department of Clinical Sciences, Lund University, Lund, Sweden
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