This article is more than 5 years old. Information may no longer be current.
Lower loosening rates associated with improved biocompatibility, osteointegration of porous implants
Click Here to Manage Email Alerts
Improved biocompatibility and osteointegration of porous implants resulted in substantially lower loosening rates after total knee arthroplasty, according to recently published study findings.
Researchers conducted a search of Medline and Embase for single-arm and controlled studies published between January 1980 and December 2013 that evaluated the failure rate of total knee arthroplasty (TKA) revisions with trabecular metal (TM) cones and a structural allograft. Overall, the researchers identified 10 articles published between 2006 and 2013 that reported on the outcome of 254 TM cones in 223 revision TKAs and 17 articles that reported on a total of 551 bulk allografts used in 476 revision TKAs. Using a logistic regression model that was adjusted for discrepancies in follow-up time and the number of grafts used, the researchers compared the failure rates between the two groups.
Results showed a loosening rate of 0.9% for TM cones, which was the same as the loosening rate of the prosthesis and/or incidence of periprosthetic fracture, whereas the rate of infection necessitating surgical intervention was 2.2%.
Patients with allografts experienced a failure rate of 6.5%, where reoperation due to either loosening or fracture of the graft was required. The reoperation rate due to loosening of the prosthesis was 3.4%, and the reoperation rate due to infection was 5.5%.
In an evaluation of the 805 TM cones and allografts, the researchers noted 33 aseptic graft loosenings, which corresponded to a yearly failure rate of 0.3% for TM cones and 1% for allografts. According to study results, five grafts in the TM group became infected vs. 26 in the allograft group.
When evaluating the overall revision and re-revision rate between groups, the researchers found no statistically significant differences. However, the researchers found a tendency toward a decreased re-revision rate from all causes for TM cones. – by Casey Tingle
Disclosures: Beckmann reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
Click Here to Manage Email Alerts