Does design change in total knee arthroplasty implants affect patient-reported outcomes?

Purpose: The purpose of this study is to compare the early results of patient-reported outcomes between two generations of a total knee system.

Methods: Between June 2018 and April 2020, 121 first-generation, cemented TKAs (89 patients) and 123 s-generation, cemented TKAs (98 patients) were performed by a single surgeon. Demographic and surgical data were collected from all patients.

Instability After Primary Total Hip Arthroplasty: Dual Mobility Versus Jumbo Femoral Heads.

Background: The use of dual mobility (DM) articulations has grown substantially over the last decade to help minimize dislocation risk. The purpose of this study is to compare the results of DM articulations to jumbo femoral heads of equivalent sizes as they relate to postoperative dislocation.

Methods: This is a retrospective cohort study of primary total hip arthroplasties (THAs) performed at a single institution between 2005 and 2018.

Press-Fit Dual-Pivot Total Knee Arthroplasty: Early Results With a Minimum 2-Year Follow-Up.

Background: Ultracongruent (UC) tibial bearings are being used with increasing frequency in the United States. Evidence suggests that the use of certain UC bearings may lead to improved patient satisfaction when compared with using conventional inserts. However, little is known as to what effect the use of UC tibial inserts has on bone ingrowth in uncemented total knee arthroplasty (TKA).

Progressive Tibial Bearing Sagittal Plane Conformity in Cruciate-Retaining Total Knee Arthroplasty.

Background: We hypothesized that when the posterior cruciate ligament (PCL) is found deficient at total knee arthroplasty (TKA), using an anterior-stabilized (AS) tibial insert would provide similar function and survivorship when compared to using a more traditional cruciate-retaining (CR) bearing when the (PCL) is balanced.

Methods: A total of 1731 TKAs were performed using the same TKA design. Of them, 868 TKAs had a standard CR insert implanted (CR-S), 480 TKAs used a lipped CR insert (CR-L), and 383 TKAs used an AS insert.

Bilateral Total Hip and Knee Arthroplasties: Average 10-Year Follow-Up.

Background: The present study investigates the clinical and radiographic outcomes in patients with all 4 major lower extremity joints replaced.

Methods: A retrospective review of our institution's database identified 125 patients in whom both hips and both knees were replaced. The mean time between the first and last arthroplasty was 6.

Cemented and uncemented total hip arthroplasty using the same femoral component.

Purpose: The purpose of this study was to evaluate the same femoral component after cemented and uncemented total hip arthroplasty. The results were compared in terms of hip scores, subsidence, and survivorship.

Methods: Between 1986 and 1996, 1017 primary THAs were implanted in 882 patients using the same porous-coated, titanium-alloy, femoral component.

Use of screws and cement in revision TKA with primary or revision specific prosthesis with up to 17 years followup.

The purpose of this study was to investigate the use for screws and cement, and primary and revision specific prosthesis for revision TKA. Between July 1989 and February 2010, 839 consecutive revision TKAs were performed, with 609 knees meeting inclusion criteria. At 17 years followup, Kaplan-Meier survivorship was 0.

Heterotopic bone formation following resurfacing total hip arthroplasty.

Heterotopic bone (HO), a rare association with total hip arthroplasty (THA), has recently been shown to be more of a problem with resurfacing hip arthroplasty (RHA). It has been speculated to be the result of greater soft tissue dissection required for this procedure. HO most commonly develops in males and patients with bilateral disease.

Pain relief and functional improvement remain 20 years after knee arthroplasty.

Background: TKA provides demonstrable pain relief and improved health-related quality of life. Yet, a decline in physical function may occur over the long term despite the absence of implant-related problems.

Questions/purposes: (1) Does pain relief diminish over 20 years after TKA? (2) Does function decline over 20 years in terms of Knee Society function, knee, and walking scores? And (3) what is the patient-reported activity level at most recent followup?

Patients And Methods: We retrospectively identified 1471 patients with 1757 primary cruciate-retaining TKAs implanted between 1975 and 1989 and identified 128 living patients (8.

Low incidence of groin pain and early failure with large metal articulation total hip arthroplasty.

Background: Large-diameter metal-on-metal articulations reportedly improve stability and wear in THAs. However, some reports suggest some patients have unexplained hip and early failures with these implants. Thus, the potential benefits may be offset by these concerns.

The effect of alignment and BMI on failure of total knee replacement.

Background: The purpose of this study was to determine the effect of tibiofemoral alignment, femoral and tibial component alignment, and body-mass index (BMI) on implant survival following total knee replacement.

Methods: We retrospectively reviewed 6070 knees in 3992 patients with a minimum of two years of follow-up. Each knee was classified on the basis of postoperative alignment (overall tibiofemoral alignment and alignment of the tibial and the femoral component in the coronal plane).

"Thicker" polyethylene bearings are associated with higher failure rates in primary total knee arthroplasty.

"Thin" modular polyethylene bearings have previously been associated with failure from wear. This study examined the influence of polyethylene thickness on survivorship in primary total knee arthroplasty (TKA). Do "thinner" or "thicker" bearings fail more? Six thousand seventy primary TKAs with a single implant design were reviewed.

A comparison in proximal tibial strain between metal-backed and all-polyethylene anatomic graduated component total knee arthroplasty tibial components.

Loading in total knee arthroplasty (TKA) is multifactorial and dependent on alignment, ligament balance, patient, and implant factors. Abnormal loading has been linked to clinical failure; however, the respective contribution of each factor to failure is not well known. This study defined the effect of metal backing on loading patterns in the proximal tibia.

Effects of coronal plane conformity on tibial loading in TKA: a comparison of AGC© flat versus conforming articulations.

Conforming articulations potentially decrease polyethylene contact stresses in total knee arthroplasty (TKA); however, less is known about the effect of coronal geometry on tibial loading and clinical failure. This study examined the relationship between coronal plane geometry and loading patterns in the proximal tibia. Composite tibiae were implanted with modular, metal-backed tibial trays and were compressively loaded with conforming and nonconforming ultra-high molecular weight polyethylene (UHMWPE) tibial bearings and comparable femoral components.

The effects of bone resection depth and malalignment on strain in the proximal tibia after total knee arthroplasty.

The clinical significance of tibial resection depth in total knee arthroplasty (TKA) is not clearly understood. The purpose of this study was to quantify the effect of tibial resection depth in TKA on tibial loading. Tibiae were coated with a photoelastic resin enabling full-field dynamic shear strain quantification in the tibial metaphysis during TKA loading.

Effects of femoral component size on proximal tibial strain with anatomic graduated components total knee arthroplasty.

Survivorship in total knee arthroplasty (TKA) is multifactorial and dependent upon alignment, ligament balance, patient characteristics, and implant factors. The contribution of each factor leading to implant loosening is not well known. This study defined the effect of femoral component sizing relative to tibial size on loading patterns in the proximal tibia.

Implant migration and failure in total knee arthroplasty is related to body mass index and tibial component size.

Aseptic loosening of knee implants is multifactorial. The purpose of this study was to examine the role of body mass index and tibial component size on loosening and migration of total knee arthroplasty (TKA) implants. Six thousand five hundred forty-eight primary TKAs (anatomic graduated components) were studied with aseptic loosening as the end point.

The prescreening history and physical in elective total joint arthroplasty.

During 2002 and 2003, 1438 patients underwent a complete medical history and physical by the same hospital-based prescreening program before elective total joint arthroplasty to determine the benefits of this preoperative examination. Sixty percent of patients were female. Mean age was 67.

Ultraviolet lighting during orthopaedic surgery and the rate of infection.

Background: Ultraviolet lighting is an alternative to laminar airflow in the operating room that may be as effective for lowering the number of environmental bacteria and possibly lowering infection rates by killing the bacteria rather than simply reducing the number at the operative site. The purpose of the present study was to compare the infection rates following joint replacement procedures performed by one orthopaedic surgeon with and without the use of ultraviolet lighting.

Methods: From July 1986 to July 2005, one surgeon performed 5980 total joint replacements at one facility.

A clinical comparison of patellar tracking using the transepicondylar axis and the posterior condylar axis.

Two different methods for femoral component rotation in total knee arthroplasty (TKA) were compared with regard to the need for lateral retinacular release and 3-year follow-up knee society scores of both patellofemoral function and 3-year radiographs of the patella. The posterior condylar axis was used in 1322 consecutive primary TKAs, and the transepicondylar axis (TEA) was used in 1059 consecutive primary TKA. A significant decrease in lateral retinacular release was observed from 56.

Mobile magic: try it, you'll like it.

Mobility affords conformity that results in less polyethylene stress and perhaps less load on the underlying bone. Wear has been documented to be less. There are excellent long-term data on large numbers of patients, and I would submit that if you try it, both you and your patients will love it.