Primary KneeSimilar Risk of Revision After Kinematically Aligned, Patient-Specific Instrumented Total Knee Arthroplasty, and All Other Total Knee Arthroplasty: Combined Results From the Australian and New Zealand Joint Replacement Registries
Section snippets
Material and Methods
Data were obtained from the Australian and New Zealand national joint replacement registries from January 1, 2011 to December 31, 2013. Inclusion criteria were primary TKAs performed for a diagnosis of osteoarthritis using the cruciate-retaining (CR) Triathlon Total Knee Replacement system (Stryker). TKAs performed using the OtisKnee (OtisMed)/ShapeMatch PSI (Stryker) were compared with all other Triathlon TKAs implanted using conventional or navigated instrumentation. The period was chosen as
Results
A total of 20,512 primary Triathlon CR TKAs were included. Of these, 416 cases were performed using KA-PSI. The gender distribution between the cohorts was identical (Table 1). Patients in the KA-PSI cohort were younger than in the other TKA cohort (mean age 66.8 ± standard deviation 8.2 vs 68.3 ± 9.2). PSI-KA TKA was implanted by 29 surgeons in 29 hospitals. Other TKAs were implanted by 507 surgeons in 243 hospitals. In the other TKA group, 48.6% were computer assisted, and 51.4% were
Discussion
In this combined national joint registry study, we found no difference in revision rates between kinematically aligned TKA performed using PSI compared with computer-assisted and conventionally instrumented TKA of the same implant. There was a difference in reasons for revision between the groups with the KA-PSI group predominantly being revised because of patellofemoral issues. Although many authors have expressed concern regarding the effect of KA alignment on implant survivorship, in this
Conclusions
This multinational registry analysis demonstrated similar midterm revision risk between KA-PSI Triathlon CR TKAs and all other Triathlon CR TKAs. These 2 groups should receive a long-term follow-up for further comparison.
Acknowledgments
The authors thank the AOANJRR and the hospitals, orthopedic surgeons, and patients whose data made this work possible. The Australian government funds the AOANJRR through the Department of Health and Aging.
References (26)
- et al.
Alignment options for total knee arthroplasty: a systematic review
Orthop Traumatol Surg Res
(2017) - et al.
Custom-fit total knee arthroplasty (OtisKnee) results in malalignment
J Arthroplasty
(2008) - et al.
Implant survival and function ten years after kinematically aligned total knee arthroplasty
J Arthroplasty
(2018) - et al.
Does kinematic alignment and flexion of a femoral component designed for mechanical alignment reduce the proximal and lateral reach of the trochlea?
J Arthroplasty
(2016) - et al.
Kinematic alignment of current TKA implants does not restore the native trochlear anatomy
Orthop Traumatol Surg Res
(2018) - et al.
Accurate alignment and high function after kinematically aligned TKA performed with generic instruments
Knee Surg Sports Traumatol Arthrosc
(2013) - et al.
Mechanical, anatomical, and kinematic axis in TKA: concepts and practical applications
Curr Rev Musculoskelet Med
(2014) - et al.
The Chitranjan S. Ranawat Award: no difference in 2-year functional outcomes using kinematic versus mechanical alignment in TKA: a randomized controlled clinical trial
Clin Orthop Relat Res
(2017) - et al.
Three-dimensional mechanics, kinematics, and morphology of the knee viewed in virtual reality
J Bone Joint Surg Am
(2005) Calipered kinematically aligned total knee arthroplasty: an accurate technique that improves patient outcomes and implant survival
Orthopedics
(2019)
Computer-assisted total knee arthroplasty using patient-specific templating
Clin Orthop Relat Res
Results of an initial experience with custom-fit positioning total knee arthroplasty in a series of 48 patients
Orthopedics
A randomised controlled trial of kinematically and mechanically aligned total knee replacements: two-year clinical results
Bone Joint J
Cited by (0)
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2020.05.065.
The research has been performed at the North Shore Hospital and the Australian Orthopaedic Association National Joint Replacement Registry.