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Modular Metal-Backed Tibial Components Provide Minimal Mid-Term Survivorship Benefits Despite Increased Cost and Frequency of Use: A Retrospective Review of the American Joint Replacement Registry Database.
Kelley, Benjamin; Mullen, Kyle; De, Ayushmita; Sassoon, Adam.
Afiliación
  • Kelley B; Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA.
  • Mullen K; American Joint Replacement Registry, American Academy of Orthopaedic Surgeons, Chicago, IL.
  • De A; American Joint Replacement Registry, American Academy of Orthopaedic Surgeons, Chicago, IL.
  • Sassoon A; Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA.
J Arthroplasty ; 37(8): 1570-1574.e1, 2022 08.
Article en En | MEDLINE | ID: mdl-35189294
ABSTRACT

BACKGROUND:

Previous studies have demonstrated equivalent survivorship of modular metal-backed tibial (MBT) and all-polyethylene tibial (APT) components. The purpose of this study is to compare the utilization and outcomes of APT and MBT components in a large US database.

METHODS:

The American Joint Replacement Registry was queried to identify all patients undergoing primary total knee arthroplasty (TKA) during the study period from 2012 to 2019. These patients were divided into cohorts based on tibial component (APT or MBT). Cohort demographics including gender, hospital size, hospital teaching status, region, age, and Charlson Comorbidity Index were reported with descriptive statistics. Overall reoperation rates and revisions for infection, aseptic loosening, periprosthetic fracture, manipulation under anesthesia, and revision for other reasons were identified using International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes and compared across APT and MBT cohorts. Kaplan-Meir survival analysis was performed based on reason for reoperation for APT and MBT.

RESULTS:

During the study period, 703,007 TKAs were reported with 97.8% utilizing MBT and 2.2% utilizing APT components. Despite the introduction of alternative payment models during the study period, the utilization of APT decreased from 5.8% in 2012 to 1.7% in 2019. The survival of APT and MBT TKAs were similar across the study period 98.1% vs 98.6% at 8 years. The rate of reoperation for all-causes was higher for APT compared to MBT (1.36% vs 1.00%; odds ratio 1.52).

CONCLUSION:

Despite their paucity of use and lower cost APT remained within a 0.4% margin of survivorship when compared to MBT implants for up to 8 years. LEVEL OF EVIDENCE Level III, retrospective.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Prótesis de la Rodilla Tipo de estudio: Health_economic_evaluation / Observational_studies Límite: Humans Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2022 Tipo del documento: Article País de afiliación: Canadá

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Prótesis de la Rodilla Tipo de estudio: Health_economic_evaluation / Observational_studies Límite: Humans Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2022 Tipo del documento: Article País de afiliación: Canadá