Short-term clinical and radiological comparisons between two Medial Pivot Total Knee Arthroplasty implants with different geometries

Eugenio Vecchini; Ramazzini Leandro; Enrico Lunardelli; Fabio Zancanaro; Andrea Amarossi; Angela Anselmi; Damiano De Cristan; Tommaso Maluta; Bruno Magnan; Matteo Ricci

doi:10.23750/abm.v94iS2.13766

Short-term clinical and radiological comparisons between two Medial Pivot Total Knee Arthroplasty implants with different geometries

Authors

Eugenio Vecchini
Ramazzini Leandro
Enrico Lunardelli
Fabio Zancanaro
Andrea Amarossi a:1:{s:5:"en_US";s:57:"Orthopaedics and Surgery Department. University of Verona";}
Angela Anselmi
Damiano De Cristan
Tommaso Maluta
Bruno Magnan
Matteo Ricci

DOI: https://doi.org/10.23750/abm.v94iS2.13766

Keywords:

Total Knee Arthroplasty - Medial Pivot - Ball in socket - J curve – Kinematics

Abstract

Background and aim: Different total knee arthroplasty (TKA) implants were created for the treatment of severe symptomatic gonarthrosis and Medial Pivot TKA (MP TKA) seem to reproduce the normal kinematics of the knee. We compare two different prosthetic designs of MP TKA in order to identify whether there is a difference between the two in terms of degree of patient satisfaction. Methods: A total of 89 patients were analyzed. A group of 46 patients who benefited from a TKA with the Evolution® prosthesis and one of 43 patients who received a TKA with the Persona® prosthesis. KSS, OKS, FJS and the ROM were analyzed at follow up. Results: The values of KSS and OKS were similar between the two groups (p>0,05). Our statistical analysis revealed a statistically significant increase (p <0.05) in ROM in the Persona® group and in FJS in the Evolution® group. No radiolucent lines were observed in both groups at the radiological final follow-up. Conclusions: MP TKA models analysed are a valuable tool to achieve satisfactory clinical outcomes. This study demonstrates that the FJS is an important score for the evaluation of patient’s satisfaction: a ROM’s limitation can be accepted by the patient in exchange for a more natural perceived knee.

References

Primorac D, Molnar V, Rod E et al. Knee osteoarthritis: A review of pathogenesis and state-of-the-art non-operative therapeutic considerations. Genes (Basel) 2020;11:1–35. https://doi.org/10.3390/genes11080854.

Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. The Lancet 2019;393:1745–59. https://doi.org/10.1016/S0140-6736(19)30417-9.

Nguyen U-SD, Zhang Y, Zhu Y, Niu J, Zhang B, Felson DT. Increasing Prevalence of Knee Pain and Symptomatic Knee Osteoarthritis: Survey and Cohort Data. 2011.

Mathijssen NMC, Verburg H, London NJ, Landsiedl M, Dominkus M. Patient reported outcomes and implant survivorship after Total knee arthroplasty with the persona knee implant system: Two year follow up. BMC Musculoskelet Disord 2019;20. https://doi.org/10.1186/s12891-019-2470-y.

Rajgopal A, Aggarwal K, Khurana A, Rao A, Vasdev A, Pandit H. Gait Parameters and Functional Outcomes After Total Knee Arthroplasty Using Persona Knee System With Cruciate Retaining and Ultracongruent Knee Inserts. J Arthroplasty 2017;32:87–91. https://doi.org/10.1016/j.arth.2016.06.012.

Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open 2012;2:e000435. https://doi.org/10.1136/BMJOPEN-2011-000435.

Liu S, Long H, Zhang Y, Ma B, Li Z. Meta-Analysis of Outcomes of a Single-Radius Versus Multi-Radius Femoral Design in Total Knee Arthroplasty. J Arthroplasty. 2016 Mar;31(3):646-54. doi: 10.1016/j.arth.2015.10.017. Epub 2015 Oct 26. PMID: 26614746.

Stiehl JB, Komistek RD, Dennis DA, Paxson RD, Hoff WA. Fluoroscopic analysis of kinematics after posterior-cruciate-retaining knee arthroplasty. J Bone Joint Surg Br. 1995 Nov;77(6):884-9. PMID: 7593100.

Ishii Y, Terajima K, Koga Y, Bechtold JE. Screw home motion after total knee replacement. Clin Orthop Relat Res 1999:181–7. https://doi.org/10.1097/00003086-199901000-00022.

Hallén LG, Lindahl O. Acta Orthopaedica Scandinavica The “Screw-Home” Movement in the Knee-Joint 2009. https://doi.org/10.3109/17453676608989407.

Komistek RD, Dennis DA, Mahfouz M. In vivo fluoroscopic analysis of the normal human knee. Clin Orthop Relat Res 2003:69–81. https://doi.org/10.1097/01.BLO.0000062384.79828.3B.

Pinskerova V, Iwaki H, Freeman MA. The shapes and relative movements of the femur and tibia at the knee. Orthopade. 2000 Jun;29 Suppl 1:S3-5. doi: 10.1007/pl00003679. PMID: 10929342.

Sabatini L, Risitano S, Parisi G et al. Medial pivot in total knee arthroplasty: Literature review and our first experience. Clin Med Insights Arthritis Musculoskelet Disord 2018;11. https://doi.org/10.1177/1179544117751431.

Hollister AM, Jatana S, Singh AK, Sullivan WW, Lupichuk AG. The axes of rotation of the knee. Clin Orthop Relat Res 1993:259—268.

Vecchini E, Christodoulidis A, Magnan B, Ricci M, Regis D, Bartolozzi P. Clinical and radiologic outcomes of total knee arthroplasty using the Advance Medial Pivot prosthesis. A mean 7years follow-up. Knee 2012;19:851–5. https://doi.org/10.1016/j.knee.2012.04.002.

Katchky AM, Jones CW, Walter WL, Shimmin AJ. Medial ball and socket total knee arthroplasty: five-year clinical results. The Bone & Joint Journal 2019;101-B:59—65. https://doi.org/10.1302/0301-620x.101b1.bjj-2018-0434.r1.

Ewald FC. The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 1989:9—12.

Victor J, Banks S, Bellemans J, Victor J, Banks S, Bellemans J. Kinematics of posterior cruciate ligament-retaining and-substituting total knee arthroplasty: a prospective randomised outcome study. J Bone Joint Surg 2005. https://doi.org/10.1302/0301-620X.87B5.

Digennaro V, Zambianchi F, Marcovigi A, Mugnai R, Fiacchi F, Catani F. Design and kinematics in total knee arthroplasty. Int Orthop 2014;38:227–33. https://doi.org/10.1007/s00264-013-2245-2.

Schmidt R, Komistek RD, Blaha JD, Penenberg BL, Maloney WJ. Fluoroscopic analyses of cruciate-retaining and Medial Pivot knee implants. Clin Orthop Relat Res, vol. 410, Lippincott Williams and Wilkins; 2003, p. 139–47. https://doi.org/10.1097/01.blo.0000063565.90853.a4.

De Jong RJ, Heesterbeek PJC, Wymenga AB. A new measurement technique for the tibiofemoral contact point in normal knees and knees with TKR. Knee Surgery, Sports Traumatology, Arthroscopy 2010;18:388–93. https://doi.org/10.1007/s00167-009-0986-7.

Zambianchi F, FF, LV, VL, MA, GA, CF. Changes in total knee arthroplasty design affect in-vivo kinematics in a redesigned total knee system: A fluoroscopy study . Clin Biomech (Bristol, Avon) 2018;54:92–102.

Karachalios T, Varitimidis S, Bargiotas K, Hantes M, Roidis N, Malizos KN. An 11- to 15-year clinical outcome study of the Advance Medial Pivot total knee arthroplasty: pivot knee arthroplasty. Bone Joint J. 2016 Aug;98-B(8):1050-5. doi: 10.1302/0301-620X.98B8.36208. PMID: 27482016.

Bae DK, Cho S Do, Im SK, Song SJ. Comparison of Midterm Clinical and Radiographic Results Between Total Knee Arthroplasties Using Medial Pivot and Posterior-Stabilized Prosthesis-Matched Pair Analysis. J Arthroplasty 2016;31:419–24. https://doi.org/10.1016/j.arth.2015.09.038.

Benjamin B, Pietrzak JRT, Tahmassebi J, Haddad FS. A functional comparison of medial pivot and condylar knee designs based on patient outcomes and parameters of gait n.d. https://doi.org/10.1302/0301-620X.100B1.

Luo Z, Luo Z, Wang H, Xiao Q, Pei F, Zhou Z. Long-term results of total knee arthroplasty with single-radius versus multi-radius posterior-stabilized prostheses. J Orthop Surg Res 2019;14. https://doi.org/10.1186/s13018-019-1183-0.

Mannan K, Scott G. The Medial Rotation total knee replacement: a clinical and radiological review at a mean follow-up of six years. J Bone Joint Surg Br. 2009 Jun;91(6):750-6. doi: 10.1302/0301-620X.91B6.22124. PMID: 19483227.

Shakespeare D, Ledger M, Kinzel V. Flexion after total knee replacement. A comparison between the Medial Pivot knee and a posterior stabilised implant. Knee 2006;13:371–3. https://doi.org/10.1016/j.knee.2006.05.007.

Luo Z, Zhou K, Wang H, Pei F, Zhou Z. Comparison between Mid-Term Results of Total Knee Arthroplasty with Single-Radius versus Multiple-Radii Posterior-Stabilized Prostheses. J Knee Surg. 2022 Jan;35(2):204-214. doi: 10.1055/s-0040-1713897. Epub 2020 Jul 13. PMID: 32659818.

Ritter MA, Harty LD, Davis KE, Meding JB, Berend ME. Predicting range of motion after total knee arthroplasty. Clustering, log-linear regression, and regression tree analysis. J Bone Joint Surg Am 2003;85:1278—1285. https://doi.org/10.2106/00004623-200307000-00014.

Parsley BS, Engh GA, Dwyer KA. Preoperative flexion. Does it influence postoperative flexion after posterior-cruciate-retaining total knee arthroplasty? Clin Orthop Relat Res 1992:204-210.

Baker PN, van der Meulen JH, Lewsey J, Gregg PJ; National Joint Registry for England and Wales. The role of pain and function in determining patient satisfaction after total knee replacement. Data from the National Joint Registry for England and Wales. J Bone Joint Surg Br. 2007 Jul;89(7):893-900. doi: 10.1302/0301-620X.89B7.19091. PMID: 17673581.

Indelli PF, Morello F, Ghirardelli S, Fidanza A, Iannotti F, Ferrini A. No clinical differences at the 2-year follow-up between single radius and J-curve medial pivot total knee arthroplasty in the treatment of neutral or varus knees. Knee Surg Sports Traumatol Arthrosc. 2020 Dec;28(12):3949-3954. doi: 10.1007/s00167-020-05854-4. Epub 2020 Feb 13. PMID: 32055879.

Samy DA, Wolfstadt JI, Vaidee I, Backstein DJ. A Retrospective Comparison of a Medial Pivot and Posterior-Stabilized Total Knee Arthroplasty With Respect to Patient-Reported and Radiographic Outcomes. J Arthroplasty. 2018 May;33(5):1379-1383. doi: 10.1016/j.arth.2017.11.049. Epub 2017 Dec 7. PMID: 29276117.