Medial-stabilized TKA may lead to better clinical outcomes vs posterior-stabilized TKA
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Results presented here showed statistically better clinical outcomes and shorter tourniquet times among patients undergoing total knee arthroplasty who received a medial-stabilized implant compared with a posterior-stabilized implant.
David F. Scott, MD, and colleagues randomly assigned 200 patients undergoing elective primary TKA to receive either a posterior-stabilized (n=99) or a medial-stabilized (n=101) device. Researchers collected the Knee Society Score, the Forgotten Joint Score and X-rays preoperatively and postoperatively at 6 weeks, 6 months and annually.
Of the 200 patients included in the study, Scott noted 171 patients were available for follow-up at 2 years postoperatively.
“There were no statistically significant differences in any of the preoperative characteristics,” Scott said in his presentation at the American Association of Hip and Knee Surgeons Annual Meeting. “There were, however, significant differences in flexion, the Knee Society Pain Motion Score and the Forgotten Joint Score starting as early as 6 months postoperatively.”
Scott added tourniquet time was 7% longer among patients in the posterior-stabilized group. At 1 year postoperatively, he noted patients had no differences in Knee Society Function Score and coronal X-ray alignment.
Although patients in the posterior-stabilized group had good to excellent Knee Society Pain Motion Scores from 6 months to 2 years postoperatively, Scott noted patients in the medial-stabilized group had substantially better results. Similarly, results showed a similar trend at 1 year and 2 years with the Forgotten Joint Score, with a 10-point improvement found in the Forgotten Joint Score at 2 years among patients in the medial-stabilized group, according to Scott.
“Likewise, flexion showed a similar trend with good to excellent results in the [posterior-stabilized] PS group, but yet better results in the [medial-stabilized] MS group, showing about an 8° flexion improvement for the MS group at the 2-year time point,” Scott said.
Results showed three patients experienced deep vein thrombosis, one patient experienced pulmonary embolism and there was no occurrence of infection. Scott added two patients underwent reoperations.
“The superior 2-year clinical results obtained with this MS knee warrants further continued follow-up and, also, I believe evaluation of other MS implants by other investigators,” Scott said.
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Scott DF, et al. Paper 15. Presented at: American Association of Hip and Knee Surgeons Annual Meeting. Nov. 11-14, 2021; Dallas (hybrid meeting).
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