May 20, 2019
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Few knee replacement constructs found to be noninferior to contemporary benchmark

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In a recently published study, researchers found few knee replacement constructs were noninferior to a contemporary benchmark construct.

Adrian E. Sayers, BSc (Leeds), MSc (Bristol), MSc & PgDip (LSHTM), and colleagues used a noninferiority analysis to compare the performance of knee replacement constructs by brand with the best performing construct registered in the National Joint Registry between April 2003 to December 2016. Researchers estimated construct failure using the 1-Kaplan-Meier method, and tested the difference in failure between the contemporary benchmark construct and all other constructs.

Adrian E. Sayers

Results showed 27 of the 449 different knee replacement constructs used had 500 or more procedures at risk at 10 years post-primary. Researchers found 18 of the 27 knee replacement constructs were classified as inferior to the benchmark by at least 20% relative risk of failure. Of these 18, researchers noted two were unicondylar constructs that were inferior by at least 100% relative risk.

At 7 years post-primary, 44% of constructs in men aged 55 to 75 years were inferior by at least 20% to the benchmark. Researchers also found 25% of constructs were inferior in women aged 55 to 75 years. Compared to the contemporary benchmark, results showed few constructs were classified as noninferior.

“This is the first time that all the different implant combinations used in England and Wales in the last 14 years have been directly compared and results are available to everyone,” Sayers, senior author of the study from the Musculoskeletal Research Unit in the Bristol Medical School, Translational Health Sciences, told Healio.com/Orthopedics. “This gives patients the opportunity to discuss with their surgeon the choice of implants they intend to use and see how they perform in comparison to other implants. This research will empower patients and surgeons and help in the decision-making process.” – by Casey Tingle

Disclosures: Sayers reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.