TY - JOUR
T1 - Peri-apatite coating decreases uncemented tibial component migration
T2 - long-term RSA results of a randomized controlled trial and limitations of short-term results
AU - Van Hamersveld, Koen T.
AU - Marang-Van De Mheen, Perla J.
AU - Nelissen, Rob G.H.H.
AU - Toksvig-Larsen, Sören
N1 - .
PY - 2018
Y1 - 2018
N2 - Background and purpose — Biological fixation of uncemented knee prostheses can be improved by applying hydroxyapatite coating around the porous surface via a solution deposition technique called Peri-Apatite (PA). The 2-year results of a randomized controlled trial, evaluating the effect of PA, revealed several components with continuous migration in the second postoperative year, particularly in the uncoated group. To evaluate whether absence of early stabilization is diagnostic of loosening, we now present long-term follow-up results. Patients and methods — 60 patients were randomized to PA-coated or uncoated (porous only) total knee arthroplasty of which 58 were evaluated with radiostereometric analysis (RSA) performed at baseline, at 3 months postoperatively and at 1, 2, 5, 7, and 10 years. A linear mixed-effects model was used to analyze the repeated measurements. Results — PA-coated components had a statistically significantly lower mean migration at 10 years of 0.94 mm (95% CI 0.72–1.2) compared with the uncoated group showing a mean migration of 1.72 mm (95% CI 1.4–2.1). Continuous migration in the second postoperative year was seen in 7 uncoated components and in 1 PA-coated component. All of these implants stabilized after 2 years except for 2 uncoated components. Interpretation — Peri-apatite enhances stabilization of uncemented components. The number of components that stabilized after 2 years emphasizes the importance of longer follow-up to determine full stabilization and risk of loosening in uncemented components with biphasic migration profiles.
AB - Background and purpose — Biological fixation of uncemented knee prostheses can be improved by applying hydroxyapatite coating around the porous surface via a solution deposition technique called Peri-Apatite (PA). The 2-year results of a randomized controlled trial, evaluating the effect of PA, revealed several components with continuous migration in the second postoperative year, particularly in the uncoated group. To evaluate whether absence of early stabilization is diagnostic of loosening, we now present long-term follow-up results. Patients and methods — 60 patients were randomized to PA-coated or uncoated (porous only) total knee arthroplasty of which 58 were evaluated with radiostereometric analysis (RSA) performed at baseline, at 3 months postoperatively and at 1, 2, 5, 7, and 10 years. A linear mixed-effects model was used to analyze the repeated measurements. Results — PA-coated components had a statistically significantly lower mean migration at 10 years of 0.94 mm (95% CI 0.72–1.2) compared with the uncoated group showing a mean migration of 1.72 mm (95% CI 1.4–2.1). Continuous migration in the second postoperative year was seen in 7 uncoated components and in 1 PA-coated component. All of these implants stabilized after 2 years except for 2 uncoated components. Interpretation — Peri-apatite enhances stabilization of uncemented components. The number of components that stabilized after 2 years emphasizes the importance of longer follow-up to determine full stabilization and risk of loosening in uncemented components with biphasic migration profiles.
UR - http://www.scopus.com/inward/record.url?scp=85046642908&partnerID=8YFLogxK
U2 - 10.1080/17453674.2018.1469223
DO - 10.1080/17453674.2018.1469223
M3 - Article
C2 - 29741133
AN - SCOPUS:85046642908
SN - 1745-3674
VL - 89
SP - 425
EP - 430
JO - Acta Orthopaedica
JF - Acta Orthopaedica
IS - 4
ER -