No clinical difference between TiN-coated versus uncoated cementless CoCrMo mobile-bearing total knee arthroplasty; 10-year follow-up of a randomized controlled trial

被引:11
作者
Louwerens, Jan K. G. [1 ]
Hockers, Niels [1 ]
Achten, Gijs [1 ]
Sierevelt, Inger N. [1 ]
Nolte, Peter A. [1 ]
van Hove, Ruud P. [2 ]
机构
[1] Spaarne Gasthuis Hosp, Dept Orthopaed Surg, Hoofddorp, Netherlands
[2] Jeroen Bosch Hosp, Dept Orthopaed Surg, Shertogenbosch, Netherlands
关键词
Titanium-nitride; Patient outcome assessment; Coating; Total knee replacement; PROSTHETIC FEMORAL HEADS; TITANIUM-NITRIDE; POSTOPERATIVE PAIN; WEAR; REPLACEMENT; PERFORMANCE; OUTCOMES; BENEFIT;
D O I
10.1007/s00167-020-05997-4
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
Purpose Improvement of biomechanical properties of cobalt-chromium-molybdenum (CoCrMo) implant surface and reduction of adhesive wear is achieved by titanium-nitride (TiN) coating in vitro. Less pain, higher postoperative outcome scores and a lower revision rate after TKA with a TiN-coated CoCrMo TKA compared with uncoated CoCrMo TKA after 10-year follow-up was hypothesized. Methods In a double-blinded RCT, 101 patients received a cementless mobile-bearing CoCrMo TKA, either TiN-coated or uncoated. The primary outcome measure was the visual analogue scale (VAS) score for pain and secondary outcome measures were the Knee Society Score (KSS), Oxford Knee Score (OKS), revision rate and adverse events. Patients were assessed at 6 weeks, 6 months, 1 year, 5 years and 10 years, postoperatively. Results 68 patients (67%) were available for 10-year follow-up. No difference was found in any of the assessed outcome measures with a mean decrease in VAS score (31.6 +/- 22.9) and a mean increase in OKS (10.9 +/- 8.4), KSS (29.3 +/- 31.4), KSSK (26.4 +/- 18.2) and KSSF (4.1 +/- 22.9). Overall revision rate was 7% (coated 6% vs uncoated 8%) without additional revision procedures between 5 and 10-year follow-up. Conclusions The in vitro potential benefits of TiN coating did not result in better clinical outcome when compared to an uncoated cementless TKA. Pain, functional outcome and revision rates were comparable after 10-year follow-up. TiN-coated cementless TKA provides comparable good long-term results, similar to uncoated cementless CoCrMo TKA. Netherlands Trial Register NL2887/NTR3033.
引用
收藏
页码:750 / 756
页数:7
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