期刊
JOURNAL OF ARTHROPLASTY
卷 36, 期 7, 页码 S221-S226出版社
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2021.02.032
关键词
patella; metal-backed patella; cementless; total knee arthroplasty; clinical outcomes
类别
The study evaluated a novel cementless metal-backed patellar component and showed excellent clinical and radiographic outcomes at 2-year and 5-year follow-up. The component demonstrated high biologic fixation rates and stability, with improvements in clinical scores observed over time.
Background: Enhanced implant longevity through biological fixation is achievable using cementless total knee arthroplasty but concerns about patellar component failure have lingered because of prior experiences with older component designs. A new metal-backed patella (MBP) design was released which features a 3-dimensional printed porous titanium metal backing to improve biologic fixation potential and a unique compression molding technique to create a stronger interlock layer between the polyethylene and metal backing. Our study purpose was to determine the clinical and radiographic outcomes and survivorship of this novel cementless MBP. Methods: Our institutional registry identified 388 cementless MBP with minimum 2-year and 80 with minimum 5-year follow-up. Knee Injury and Osteoarthritis Outcome Score for Joint Replacement and 12-item Veterans RAND/Short Form Health Survey (VR/SF-12) scores were used to evaluate clinical outcomes. Aseptic loosening noted on radiographs as well as revision for any reason were the end points used to determine survivorship. Results: Improvement in the preoperative Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, VR/SF-12 physical health and mental health scores were all statistically significant at 2-year follow-up and the VR/SF-12 mental health score at 5-year follow-up. By radiologic criteria, biologic fixation of the patellar component was present in all except 1 case at 2 years (99.6%) and at 5 years (97.7%). Radiolucent lines were present in 15 cases (6.2%) at 2 years and in 6 cases (14%) at 5 years, but progressive increase in radiolucent lines was seen in only 4 cases. No component was revised for loosening; aseptic survivorship was 100%. Conclusion: This 3-dimensional printed cementless patellar component shows excellent survivorship at 2-year and 5-year follow-up. We are hopeful about the long-term durability of this implant. (C) 2021 Elsevier Inc. All rights reserved.
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