A randomized RSA study concentrating especially on continuous migration

Mats Molt, Leif Ryd, Sören Toksvig-Larsen, Mats Molt, Leif Ryd, Sören Toksvig-Larsen

Abstract

Background and purpose - There is a general call for phased introduction of new implants, and one step in the introduction is an early evaluation of micromotion. We compared the micromotion in the Triathlon and its predecessor, the Duracon total knee prosthesis, concentrating especially on continuous migration over 5 years of follow-up. Patients and methods - 60 patients were randomized to receive either a cemented Triathlon total knee prosthesis or a cemented Duracon total knee prosthesis. 3-D tibial component migration was measured by radiostereometric analysis (RSA) at 3 months and at 1, 2, and 5 years. Results - There was no statistically significant difference in maximum total point motion (MTPM) between the 2 groups (p = 0.1). The mean MTPM at 5 years for the Duracon was 1.10 (SD 1.21) mm and for the Triathlon it was 0.66 (SD 0.38) mm. The numbers of continuously migrating prostheses were similar in the groups at the fifth year of follow-up; 6 of 21 prostheses in the Duracon group and 3 of 21 in the Triathlon group had migrated more than 0.3 mm between the second year and the fifth year of follow-up (p = 0.2). Interpretation - The Triathlon has a micromotion pattern similar to that of the Duracon total knee system at both short-term and medium-term follow-up, and may therefore, over time, show the same good long-term mechanical stability.

Figures

Figure 1.
Figure 1.
Consort fl ow chart
Figure 2.
Figure 2.
Box plots of median MTPM of the Triathlon group (left) and the Duracon group (right) at 1 year, 2 years, and 5 years. The horizontal hatched line denotes 0.5 mm. The central red line denotes the median value. The box denotes the second and third quartiles. The whiskers denote the range, excluding outliers. Dots denote outliers.
Figure 3.
Figure 3.
The numbers of patients who were classifi ed as stable at 1, 2, and 5 years were 21, 31, and 34, respectively, depending on the choice of method: MTPM

Figure 4.

The numbers of patients classifi…

Figure 4.

The numbers of patients classifi ed as having continuously migrating prostheses at 1,…

Figure 4.
The numbers of patients classifi ed as having continuously migrating prostheses at 1, 2, and 5 years were 21, 11, and 8, respectively, depending on the choice of method: MTPM
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References
    1. Ahlbäck S. Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) 1968; Suppl277: 277–2. - PubMed
    1. AOANJRR Australian Orthopaedic Association National Joint Replacement Registry. Annual Report Adelaide AOA 2013.
    1. Cohen D. Out of joint: the story of the ASR. Bmj 2011; 342: d2905. - PubMed
    1. Gothesen O, Espehaug B, Havelin L, Petursson G, Lygre S, Ellison P, Hallan G, Furnes O.. 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-b(5): 636–42. - PubMed
    1. Iwaki H. Pinskerova V, Freeman M A.. Tibiofemoral movement 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee. J Bone Joint Surg Br 2000; 82(8): 1189–95. - PubMed
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Figure 4.
Figure 4.
The numbers of patients classifi ed as having continuously migrating prostheses at 1, 2, and 5 years were 21, 11, and 8, respectively, depending on the choice of method: MTPM

References

    1. Ahlbäck S. Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) 1968; Suppl277: 277–2.
    1. AOANJRR Australian Orthopaedic Association National Joint Replacement Registry. Annual Report Adelaide AOA 2013.
    1. Cohen D. Out of joint: the story of the ASR. Bmj 2011; 342: d2905.
    1. Gothesen O, Espehaug B, Havelin L, Petursson G, Lygre S, Ellison P, Hallan G, Furnes O.. 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-b(5): 636–42.
    1. Iwaki H. Pinskerova V, Freeman M A.. Tibiofemoral movement 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee. J Bone Joint Surg Br 2000; 82(8): 1189–95.
    1. Kessler O, Durselen L, Banks S, Mannel H, Marin F.. Sagittal curvature of total knee replacements predicts in vivo kinematics. Clin Biomech 2007; 22(1): 52–8.
    1. Kärrholm J. Radiostereometric analysis of early implant migration - a valuable tool to ensure proper introduction of new implants. Acta Orthop 2012; 83(6): 551–2.
    1. Linder L. Boneloc–The Christiansen experience revisited. Acta Orthop Scand 1995; 66(3): 205–6.
    1. Malchau H.Introducing new technology: a stepwise algorithm. Spine Phila Pa 2000; 1976 25(3): 285.
    1. Molt M, Ljung P, Toksvig-Larsen S.. Does a new knee design perform as well as the design it replaces? Bone Joint Res 2012; 1(12): 315–23.
    1. NJR National Joint Registry for England and Wales, 10th Annual Report, 2013.
    1. Ostermeier S, Stukenborg-Colsman C.. Quadriceps force after TKA with femoral single radius. Acta Orthop 2011; 82(3): 339–43.
    1. Pijls B G, Valstar E R, Nouta K A, Plevier J W, Fiocco M, Middeldorp S, Nelissen R G.. Early migration of tibial components is associated with late revision. Acta Orthop 2012; 83(6): 614–624.
    1. Ryd L. Micromotion in knee arthroplasty. A roentgen stereophotogrammetric analysis of tibial component fixation. Acta Orthop Scand 1986; Suppl220: 1–80.
    1. Ryd L, Albrektsson B E, Carlsson L, Dansgard F, Herberts P, Lindstrand A, Regner L, Toksvig-Larsen S.. Roentgen stereophotogrammetric analysis as a predictor of mechanical loosening of knee prostheses. J Bone Joint Surg Br 1995; 77(3): 377–83.
    1. SKAR The Swedish Knee Arthroplasty Register. Annual Report. Lund: Dept. of Orthopedics, Skåne University Hospital, 2013.
    1. Thanner J, Freij-Larsson C, Kärrholm J, Malchau H, Wesslen B.. Evaluation of Boneloc. Chemical and mechanical properties, and a randomized clinical study of 30 total hip arthroplasties. Acta Orthop Scand 1995; 66(3): 207–14.
    1. Valstar E R, Gill R, Ryd L, Flivik G, Borlin N, Kärrholm J.. Guidelines for standardization of radiostereometry (RSA) of implants. Acta Orthop 2005; 76(4): 563–72.
    1. Wang H, Simpson K J, Ferrara M S, Chamnongkich S, Kinsey T, Mahoney O M.. Biomechanical differences exhibited during sit-to-stand between total knee arthroplasty designs of varying radii. J Arthroplasty 2006; 21(8): 1193–9.
    1. Wolterbeek N, Garling E H, Mertens B J, Nelissen R G, Valstar E R.. Kinematics and early migration in single-radius mobile- and fixed-bearing total knee prostheses. Clin Biomech 2012; 27(4): 398–402.

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