Patients at risk of knee joint complications when new technology is used

Patients who undergo the first 15 operations using a new device in a hospital are 48% more likely to need early revision surgery than patients who undergo an operation to fit a prosthesis previously used in-hospital, according to researchers in Finland.

The findings, published in Clinical Orthopaedics and Related Research, looked at the risk of early revision surgery following the introduction of a new endoprosthesis model for total knee arthroplasty (TKA).

“Patients should be informed if there is a plan to introduce a new model and offered the option to choose a conventional endoprosthesis instead,” the authors wrote. “Although introducing potentially better endoprosthesis models is important, there is a need for managed uptake of new technology.”

According to the study abstract, the authors investigated Finnish registry data for TKAs performed for primary osteoarthritis (OA) between 1998 and 2004 – a total of 28,760 TKAs in 23,707 patients. Of these TKAs, 27,105 had a follow-up of 5 years. Longer follow-ups were excluded.

The researchers reported an elevated risk for the first 15 operations with a new endoprosthesis, according to a Springer news release. This effect was noted as substantial, as those first 15 patients who received a new model endoprosthesis were at 48% greater risk than patients who underwent TKA with a conventional endoprosthesis.

The authors noted the likelihood of requiring revision surgery was greatest during the first 2 years postoperatively. There was no increased risk after the first 15 operations with the new endoprosthesis model.

Reference:

Peltola M, Malmivaara A, Paavola M. Introducing a knee endoprosthesis model increases risk of early revision surgery. Clin Orthop Relat Res. 2011. doi: 10.1007/s11999-011-2171-9