Continued Stabilization of a Cementless 3D-Printed Total Knee Arthroplasty

被引:4
作者
van der Lelij, Thies J. N. [1 ]
van de Mheen, Perla J. [2 ]
Kaptein, Bart L. [1 ]
Toksvig-Larsen, Soren [3 ,4 ]
Nelissen, Rob G. H. H. [1 ]
机构
[1] Leiden Univ, Med Ctr, Dept Orthopaed, Leiden, Netherlands
[2] Leiden Univ, Med Ctr, Dept Biomed Data Sci, Med Decis Making, Leiden, Netherlands
[3] Hassleholm Hosp, Dept Orthopaed, Hassleholm, Sweden
[4] Lund Univ, Dept Clin Sci, Lund, Sweden
关键词
ROENTGEN STEREOPHOTOGRAMMETRIC ANALYSIS; TIBIAL COMPONENT FIXATION; 5-YEAR FOLLOW-UP; EARLY MIGRATION; RSA; METAANALYSIS; IMPLANT; DESIGN; STILL; JOINT;
D O I
10.2106/JBJS.23.00221
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background:Three-dimensional (3D) printing of highly porous orthopaedic implants aims to promote better osseointegration, thus preventing aseptic loosening. However, short-term radiostereometric analysis (RSA) after total knee arthroplasty (TKA) has shown higher initial migration of cementless 3D-printed tibial components compared with their cemented counterparts. Therefore, critical evaluation of longer-term tibial component migration is needed. We investigated migration of a cementless 3D-printed and a cemented tibial component with otherwise similar TKA design during 5 years of follow-up, particularly the progression in migration beyond 2 years postoperatively.Methods:Seventy-two patients were randomized to a cementless 3D-printed Triathlon Tritanium (Stryker) cruciate-retaining (CR) TKA or a cemented Triathlon CR (Stryker) TKA implant. Implant migration was evaluated with RSA at baseline and postoperatively at 3 months and at 1, 2, and 5 years. The maximum total point motion (MTPM) of the tibial component was compared between the groups at 5 years, and progression in migration was assessed between 2 and 5 years. Individual implants were classified as continuously migrating if the MTPM was >= 0.1 mm/year beyond 2 years postoperatively. Clinical scores were evaluated, and a linear mixed-effects model was used to analyze repeated measurements.Results:At 5 years, the mean MTPM was 0.66 mm (95% confidence interval [CI], 0.56 to 0.78 mm) for the cementless group and 0.53 mm (95% CI, 0.43 to 0.64 mm) for the cemented group (p = 0.09). Between 2 and 5 years, there was no progression in mean MTPM for the cementless group (0.02 mm; 95% CI, -0.06 to 0.10 mm) versus 0.07 mm (95% CI, 0.00 to 0.14) for the cemented group. One implant was continuously migrating in the cementless group, and 4 were continuously migrating in the cemented group. The clinical scores were comparable between the groups across the entire time of follow-up.Conclusions:No significant difference in mean migration was found at 5 years between the cementless and cemented TKA implants. Progression of tibial component migration was present beyond 2 years for the cemented implant, whereas the cementless implant remained stable after initial early migration.Level of evidence:Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
引用
收藏
页码:1686 / 1694
页数:9
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