Khetan, V. orcid.org/0000-0002-7414-9356, Baxter, I., Hampton, M. et al. (2 more authors) (2024) Cementless total knee arthroplasty in young patients using tantalum trabecular implants results in significantly lower rates of aseptic loosening. Bone & Joint Open, 5 (4). pp. 277-285. ISSN 2633-1462
Abstract
Aims
The mean age of patients undergoing total knee arthroplasty (TKA) has reduced with time. Younger patients have increased expectations following TKA. Aseptic loosening of the tibial component is the most common cause of failure of TKA in the UK. Interest in cementless TKA has re-emerged due to its encouraging results in the younger patient population. We review a large series of tantalum trabecular metal cementless implants in patients who are at the highest risk of revision surgery.
Methods
A total of 454 consecutive patients who underwent cementless TKA between August 2004 and December 2021 were reviewed. The mean follow-up was ten years. Plain radiographs were analyzed for radiolucent lines. Patients who underwent revision TKA were recorded, and the cause for revision was determined. Data from the National Joint Registry for England, Wales, Northern Island, the Isle of Man and the States of Guernsey (NJR) were compared with our series.
Results
No patients in our series had evidence of radiolucent lines on their latest radiological assessment. Only eight patients out of 454 required revision arthroplasty, and none of these revisions were indicated for aseptic loosening of the tibial baseplate. When compared to data from the NJR annual report, Kaplan-Meier estimates from our series (2.94 (95% confidence interval (CI) 1.24 to 5.87)) show a significant reduction in cumulative estimates of revision compared to all cemented (4.82 (95% CI 4.69 to 4.96)) or cementless TKA (5.65 (95% CI 5.23 to 6.10)). Our data (2.94 (95% CI 1.24 to 5.87)) also show lower cumulative revision rates compared to the most popular implant (PFC Sigma Cemented Knee implant fixation, 4.03 (95% CI 3.75 to 4.33)). The prosthesis time revision rate (PTIR) estimates for our series (2.07 (95% CI 0.95 to 3.83)) were lower than those of cemented cases (4.53 (95% CI 4.49 to 4.57)) from NJR.
Conclusion
The NexGen trabecular (tantalum) cementless implant has lower revision rates in our series compared to all cemented implants and other types of cementless implants, and its use in younger patients should be encouraged.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 Khetan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https:// creativecommons.org/licenses/by-nc-nd/4.0/ |
Keywords: | Total knee arthroplasty; Uncemented TKA; Young patient; Aseptic loosening; Tantalum; Cementless total knee arthroplasty; total knee arthroplasty (TKA); tibial components; Cementless implants; National Joint Registry; revision surgery; cemented implants; trabecular metal |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 22 Apr 2024 15:27 |
Last Modified: | 22 Apr 2024 15:27 |
Status: | Published |
Publisher: | British Editorial Society of Bone & Joint Surgery |
Refereed: | Yes |
Identification Number: | 10.1302/2633-1462.54.BJO-2023-0132.R1 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:211715 |