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

2020 ◽  
Author(s):  
Jan K. G. Louwerens ◽  
Niels Hockers ◽  
Gijs Achten ◽  
Inger N. Sierevelt ◽  
Peter A. Nolte ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Randomized Controlled Trial ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Mobile Bearing ◽  
Randomized Controlled ◽  
Clinical Difference ◽  
Total Knee

A randomized controlled trial of fixed- versus mobile-bearing total knee arthroplasty

2018 ◽  
Vol 100-B (7) ◽  
pp. 925-929 ◽  
Author(s):  
M. P. Abdel ◽  
M. E. Tibbo ◽  
M. J. Stuart ◽  
R. T. Trousdale ◽  
A. D. Hanssen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Randomized Controlled Trial ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Mobile Bearing ◽  
Fixed Bearing ◽  
Randomized Controlled ◽  
Total Knee ◽  
Bearing Design ◽  
Ks Function

Aims It has been suggested that mobile-bearing total knee arthroplasty (TKA) might lead to better outcomes by accommodating some femorotibial rotational mismatch, thereby reducing contact stresses and polyethylene wear. The aim of this study was to determine whether there is a difference between fixed- and mobile-bearing versions of a contemporary TKA with respect to durability, range of movement (ROM) and function, ten years postoperatively. Patients and Methods A total of 240 patients who were enrolled in this randomized controlled trial (RCT) underwent a primary cemented TKA with one of three tibial components (all-polyethylene fixed-bearing, modular metal-backed fixed-bearing and mobile-bearing). Patients were reviewed at a median follow-up of ten years (IQR 9.2 to 10.4). Results There was no difference in durability, as measured by survivorship free of revision for any reason, nor in mean maximal ROM at ten years (p = 0.8). There was also no difference in function, as measured by Knee Society (KS) function scores (p = 0.63) or the prevalence of patellar tilt (p = 0.12). Conclusion In this clinical RCT, the mobile-bearing design of TKA was found to be reliable and durable, but did not provide better maximum knee flexion, function or durability ten years postoperatively compared with a posterior-stabilized, fixed-bearing design incorporating either an all-polyethylene or a modular-metal-backed tibial component. Cite this article: Bone Joint J 2018;100-B:925–9.

scholarly journals Barbed Sutures in Total Knee Arthroplasty: Are They Really Useful? A Randomized Controlled Trial

2019 ◽  
Vol 33 (09) ◽  
pp. 927-930 ◽  
Author(s):  
Carlo Gamba ◽  
Pedro Hinarejos ◽  
Paula Serrano-Chinchilla ◽  
Joan Leal-Blanquet ◽  
Raul Torres-Claramunt ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Randomized Controlled Trial ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Barbed Sutures ◽  
Randomized Controlled ◽  
Closure Time ◽  
Subcutaneous Layer ◽  
Total Knee

AbstractBidirectional barbed sutures (BBSs) have recently been investigated in total knee arthroplasty (TKA). The contrasting results from the scarce literature suggest that BBSs are safe, save time and money, and give results comparable to traditional sutures. The purpose of the study is to test the real effect of BBSs on closure time in TKA and assess the functional results as well as the complications related to them. It was a randomized controlled trial. Eighty-five patients undergoing primary TKA were assigned to receive traditional closure with Vicryl (V-group) or with BBSs (Q-group). The exclusion criteria were significant coronal deformity, flexion contracture, or the need for stem and/or augmentation. The closure time for the capsule and that for the subcutaneous layer were registered separately. Intraoperative incidences were recorded. The follow-up was up to 1 month, during which the range of motion (ROM), superficial or deep infection, and wound dehiscence were assessed. There was a significant reduction in the capsule layer (27 seconds; p = 0.02) and global time closure (51 seconds; p = 0.01) in the Q-group. No differences were found in the subcutaneous layer (24 seconds; p = 0.055). There were more intraoperative suture breakages in the Q-group, mainly in the subcutaneous layer (p < 0.001). No differences in terms of dehiscence, infection, and ROM were observed at the 1-month follow-up. BBSs allow for slightly faster wound closure than Vicryl during a TKA. However, the differences observed have minimal clinical repercussions. Moreover, no differences in the infection rate (deep or superficial), dehiscence, or ROM were found.

Effects of the Use of Tourniquet in Total Knee Arthroplasty on the Clinical and Functional Outcomes with 5 Years of Follow-up: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Sherwan A. Hamawandi ◽  
Hazhar I. Amin ◽  
Ameer K. Al-Humairi
Keyword(s):  
Total Knee Arthroplasty ◽  
Randomized Controlled Trial ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Controlled Trial ◽  
Thigh Pain ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Total Knee

AbstractThe use of tourniquet in total knee arthroplasty (TKA) had a lot of controversies with no clear agreement about the advantages and disadvantages of tourniquet. This study aims to show the effects of tourniquet use in TKA on the functional and clinical outcomes with follow-up of 5 years. This is a randomized, double-blind, and single-center study of 101 patients who were treated by TKA and divided randomly into two groups. Tourniquet was used in group A and was not used in group B. Both groups were assessed by Knee Society score (KSS), knee injury and osteoarthritis outcome score (KOOS), visual analogue scale (VAS) score for thigh pain, and postoperative complications. Both groups were followed up for 5 years. The group of no tourniquet showed significant better functional outcomes measured by KSS at postoperative periods of 2 weeks (p = 0.001), 6 weeks (p = 0.006), and 3 months (p = 0.034), and KOOS at postoperative periods of 2 weeks (p = 0.001), 6 weeks (p =0.001), and 3 months (p = 0.016). However, there was no significant difference in long-term follow-up of 5 years. There were significantly better results with use of tourniquet regarding surgeon's visualization during surgery, less operative time, and less calculated blood loss, while significantly better results with no use of tourniquet were reported regarding less hospital stay, less postoperative analgesic consumption, and less postoperative thigh pain measured by VAS score at postoperative periods of day 1 (p = 0.001), day 5 (p = 0.001), 2 weeks (p = 0.001), and 6 weeks (p = 0.001). Regarding postoperative blood transfusion and clinical deep venous thrombosis, there was no significant difference between use of tourniquet or not. The evidence presented in this level-1 randomized controlled trial suggests that no use of tourniquet in TKA can improve functional outcomes in early postoperative period with no significant difference on functional outcome at 5 years of follow-up.

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