Superior fixation of pegged trabecular metal over screw-fixed pegged porous titanium fiber mesh.
Background and purpose Lasting stability of cementless implants depends on osseointegration into the implant surface, and long-term implant fixation can be predicted using radiostereometric analysis (RSA) with short-term follow-up. We hypothesized that there would be improved fixation of high-porosi...
| Publicado en: | Acta Orthopaedica Vol. 82; no. 2; pp. 177 - 187 |
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| Autores principales: | , , , , , , |
| Formato: | clinical trial equations & formulas pictorial research tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
Apr2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104862821&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104862821 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: Apr2011 vid: 82 iid: 2 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 104862821 59761498 10.3109/17453674.2011.566139 NLM21434781 104862821 ppf: 177 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Superior fixation of pegged trabecular metal over screw-fixed pegged porous titanium fiber mesh. aug: au: Stilling, Maiken Madsen, Frank Odgaard, Anders Røømer, Lone Andersen, Niels Trolle Rahbek, Ole Søøballe, Kjeld affil: Department of Orthopedics sug: subj: Osteoarthritis Surgery Orthopedic Prosthesis Evaluation Orthopedic Fixation Devices Evaluation Arthroplasty, Replacement, Knee Equipment and Supplies Foreign-Body Migration Human Clinical Trials Random Assignment Prospective Studies Radiostereometric Analysis Titanium Metals Pretest-Posttest Design Descriptive Statistics T-Tests Prosthesis Design Funding Source Academic Medical Centers Denmark Adolescence Adult Middle Age Aged Male Female Scales Treatment Outcomes Patient Satisfaction Mann-Whitney U Test Wilcoxon Signed Rank Test Data Analysis Software Chi Square Test Fisher's Exact Test Paired T-Tests Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background and purpose Lasting stability of cementless implants depends on osseointegration into the implant surface, and long-term implant fixation can be predicted using radiostereometric analysis (RSA) with short-term follow-up. We hypothesized that there would be improved fixation of high-porosity trabecular metal (TM) tibial components compared to low-porosity titanium pegged porous fiber-metal (Ti) polyethylene metal backings. Methods In a prospective, parallel-group, randomized unblinded clinical trial, we compared cementless tibial components in patients aged 70 years and younger with osteoarthritis. The pre-study sample size calculation was 22 patients per group. 25 TM tibial components were fixed press-fit by 2 hexagonal pegs (TM group) and 25 Ti tibial components were fixed press-fit and by 4 supplemental screws (Ti group). Stereo radiographs for evaluation of absolute component migration (primary effect size) and single-direction absolute component migration (secondary effect size) were obtained within the first postoperative week and at 6 weeks, 6 months, 1 year, and 2 years. American Knee Society score was used for clinical assessment preoperatively, and at 1 and 2 years. Results There were no intraoperative complications, and no postoperative infections or revisions. All patients had improved function and regained full extension. All tibial components migrated initially. Most migration of the TM components (n == 24) occurred within the first 3 months after surgery whereas migration of the Ti components (n == 22) appeared to stabilize first after 1 year. The TM components migrated less than the Ti components at 1 year (p == 0.01) and 2 years (p == 0.004). Interpretation We conclude that the mechanical fixation of TM tibial components is superior to that of screw-fixed Ti tibial components. We expect long-term implant survival to be better with the TM tibial component. pubtype: Academic Journal doctype: clinical trial equations & formulas pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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