Late stabilization after initial migration in patients undergoing cemented total knee arthroplasty: a 5-year followup of 2 randomized controlled trials using radiostereometric analysis

Authors

  • Shaho Hasan Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands https://orcid.org/0000-0001-8369-1481
  • Bart L Kaptein Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands https://orcid.org/0000-0001-8772-9985
  • Perla J Marang-van de Mheen Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands https://orcid.org/0000-0003-1439-0989
  • Koen T van Hamersveld Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
  • Rob G H H Nelissen Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands https://orcid.org/0000-0003-1228-4162
  • Sören Toksvig-Larsen Department of Orthopaedics, Hässleholm Hospital, Hässleholm, Sweden and Department of Clinical Sciences, Lund University, Lund, Sweden

DOI:

https://doi.org/10.2340/17453674.2022.1381

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.

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Published

2022-01-24

How to Cite

Hasan, S., Kaptein, B. L., Marang-van de Mheen, P. J., van Hamersveld, K. T., Nelissen, R. G. H. H., & Toksvig-Larsen, S. (2022). 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, 93, 271–276. https://doi.org/10.2340/17453674.2022.1381

Issue

Section

Randomized clinical trial

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