Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty.
Knee Surg Sports Traumatol Arthrosc
; 31(4): 1316-1322, 2023 Apr.
Article
en En
| MEDLINE
| ID: mdl-35147719
ABSTRACT
PURPOSE:
Allergy against implant materials is discussed controversially and still not fully understood. Despite these controversies, a relevant number of patients receive hypoallergenic knee implants. The aim of this study was to compare a new coating system with the standard implant in total knee arthroplasty (TKA). Additionally, the influence of proinflammatory cytokines on patient-reported outcome measures (PROMs) was investigated.METHODS:
120 patients without known metal allergy and without previous metal implants were included. The patients were randomized to receive a coated or standard TKA of the same knee system. 105 patients completed the 5 year follow-up. Patient-reported outcome measures (PROMs) including knee function (Oxford Knee Score, OKS), quality of life (SF36) and UCLA activity scale were assessed. Additionally, several cytokines with a possible role in implant allergy were measured in patient`s serum (IL-1beta, IL-5, IL-6, IL-8, IL-10, IP-10, IFN γ, TNF α). Group comparison was performed using Mann-Whitney U test for continuous values and chi-square test for categorical values.RESULTS:
There were no differences in PROMs between both groups at any follow-up. The majority of patients demonstrated no elevation of the measured blood cytokines. The blood cytokine pattern after 5 years demonstrated no differences between study groups. There was a significant association between elevated IL-8 values and worse results in the overall OKS (p = 0.041), the OKS function component (p = 0.004), the UCLA activity scale (p = 0.007) and the physical component of SF36 (p = 0.001).CONCLUSION:
There were no problems with the new coating during mid-term follow-up and no differences in PROMs between coated and standard TKA. Patients with an increased inflammatory response demonstrated worse functional results, regardless of the implant. LEVEL OF EVIDENCE I. CLINICAL TRIAL REGISTRATION The study protocol was registered in the US National Institutes of Health's database ( http//www. CLINICALTRIALS gov ) registry under NCT00862511.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Artroplastia de Reemplazo de Rodilla
/
Osteoartritis de la Rodilla
/
Hipersensibilidad
/
Prótesis de la Rodilla
Tipo de estudio:
Clinical_trials
/
Guideline
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Knee Surg Sports Traumatol Arthrosc
Asunto de la revista:
MEDICINA ESPORTIVA
/
TRAUMATOLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Alemania