Newer TKR implant design had similar outcomes to more established implant design
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Although the Smith & Nephew Genesis II and Journey II bicruciate stabilized knee implants had no differences in 6-month patient-reported outcomes, results showed the Genesis II yielded significant advantages for knee range of movement.
Researchers randomly assigned 80 patients undergoing single-stage total knee replacement to receive either the Genesis II (Smith & Nephew) TKR or the Journey II bicruciate stabilized (Smith & Nephew) knee implant. Researchers considered the Oxford Knee Score (OKS) at 6 months the primary outcome, while secondary outcomes included the OKS activity and participation questionnaire, the EuroQol-5D, University of California Los Angeles activity scores, the timed-up-and-go test, the 6-minute walk test, and lower limb kinematics and lower limb muscle activity during walking and balance.
Results showed no differences in the OKS between the groups, with a mean OKS of 42.97 for patients who had the Journey II bicruciate stabilized implant and 43.13 for patients who had the Genesis II implant. Researchers found a significantly greater walking range of movement and higher peak knee flexion angular velocity during walking among patients who received the Genesis II implant. Researchers also noted patients who received the Genesis II implant had better postural control during quiet standings vs. patients who had the Journey II bicruciate stabilized implant.
“The future of design and innovation may come in the form of more modern surgical techniques, such as robotic-assisted implantation, to assist in placing the knee in a more kinematically sympathetic position, which in turn, may allow the newer design philosophies to positively influence outcome,” the authors wrote. “It is possible, only then in combination with modern surgical techniques, that improvements in patient outcomes can be realized, but well-constructed surgical trials will need to answer such questions.”
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