Mikkel Rathsach Andersen, Müjgan Yilmaz, Nikolaj Winther, Thomas Lind, Henrik Schrøder, Gunnar Flivik Flivik, Michael Mørk Petersen
{"title":"单块与模块化设计在非骨水泥全膝关节置换术中的长期迁移:一项使用放射立体分析的随机试验的二次报告。","authors":"Mikkel Rathsach Andersen, Müjgan Yilmaz, Nikolaj Winther, Thomas Lind, Henrik Schrøder, Gunnar Flivik Flivik, Michael Mørk Petersen","doi":"10.2340/17453674.2025.43904","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong> Backside wear of the polyethylene insert in total knee arthroplasty (TKA) has been described to produce clinically significant levels of polyethylene debris, which can lead to aseptic loosening and osteolysis. Monoblock design eliminates backside wear of the polyethylene and therefore could improve long-term fixation. This randomized clinical trial (RCT) using radiostereometric analysis (RSA) compares micromotion of monoblock and modular polyethylene inserts with 7 years' follow-up.</p><p><strong>Methods: </strong> 65 patients (mean age 61 years) were randomized to receive either monoblock (n = 32) or modular (n = 33) uncemented trabecular metal tibial components. 35 patients (monoblock = 18, and modular = 17) completed 7 years' follow-up. The primary endpoint of the study was maximum total point motion (MTPM). Implant translation and rotation are reported as secondary endpoints.</p><p><strong>Results: </strong> After 84 months, the modular group had a statistically significant higher mean MTPM of 1.17 (95% confidence interval [CI] 0.90-1.41) mm compared with the monoblock group of 0.78 (CI 0.55-0.88) mm (P = 0.02). However, there was no difference in continuous migration (from 12-84 months), which was 0.13 mm in the monoblock group and 0.16 mm in the modular group.</p><p><strong>Conclusion: </strong> There was significantly lower early migration in the monoblock group compared with the modular group but no difference in continuous migration after 12 months, which confirms the finding of previous publications.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"485-491"},"PeriodicalIF":2.5000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203421/pdf/","citationCount":"0","resultStr":"{\"title\":\"Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis.\",\"authors\":\"Mikkel Rathsach Andersen, Müjgan Yilmaz, Nikolaj Winther, Thomas Lind, Henrik Schrøder, Gunnar Flivik Flivik, Michael Mørk Petersen\",\"doi\":\"10.2340/17453674.2025.43904\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong> Backside wear of the polyethylene insert in total knee arthroplasty (TKA) has been described to produce clinically significant levels of polyethylene debris, which can lead to aseptic loosening and osteolysis. Monoblock design eliminates backside wear of the polyethylene and therefore could improve long-term fixation. This randomized clinical trial (RCT) using radiostereometric analysis (RSA) compares micromotion of monoblock and modular polyethylene inserts with 7 years' follow-up.</p><p><strong>Methods: </strong> 65 patients (mean age 61 years) were randomized to receive either monoblock (n = 32) or modular (n = 33) uncemented trabecular metal tibial components. 35 patients (monoblock = 18, and modular = 17) completed 7 years' follow-up. The primary endpoint of the study was maximum total point motion (MTPM). Implant translation and rotation are reported as secondary endpoints.</p><p><strong>Results: </strong> After 84 months, the modular group had a statistically significant higher mean MTPM of 1.17 (95% confidence interval [CI] 0.90-1.41) mm compared with the monoblock group of 0.78 (CI 0.55-0.88) mm (P = 0.02). However, there was no difference in continuous migration (from 12-84 months), which was 0.13 mm in the monoblock group and 0.16 mm in the modular group.</p><p><strong>Conclusion: </strong> There was significantly lower early migration in the monoblock group compared with the modular group but no difference in continuous migration after 12 months, which confirms the finding of previous publications.</p>\",\"PeriodicalId\":6916,\"journal\":{\"name\":\"Acta Orthopaedica\",\"volume\":\"96 \",\"pages\":\"485-491\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-06-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203421/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Orthopaedica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2340/17453674.2025.43904\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Orthopaedica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2340/17453674.2025.43904","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis.
Background and purpose: Backside wear of the polyethylene insert in total knee arthroplasty (TKA) has been described to produce clinically significant levels of polyethylene debris, which can lead to aseptic loosening and osteolysis. Monoblock design eliminates backside wear of the polyethylene and therefore could improve long-term fixation. This randomized clinical trial (RCT) using radiostereometric analysis (RSA) compares micromotion of monoblock and modular polyethylene inserts with 7 years' follow-up.
Methods: 65 patients (mean age 61 years) were randomized to receive either monoblock (n = 32) or modular (n = 33) uncemented trabecular metal tibial components. 35 patients (monoblock = 18, and modular = 17) completed 7 years' follow-up. The primary endpoint of the study was maximum total point motion (MTPM). Implant translation and rotation are reported as secondary endpoints.
Results: After 84 months, the modular group had a statistically significant higher mean MTPM of 1.17 (95% confidence interval [CI] 0.90-1.41) mm compared with the monoblock group of 0.78 (CI 0.55-0.88) mm (P = 0.02). However, there was no difference in continuous migration (from 12-84 months), which was 0.13 mm in the monoblock group and 0.16 mm in the modular group.
Conclusion: There was significantly lower early migration in the monoblock group compared with the modular group but no difference in continuous migration after 12 months, which confirms the finding of previous publications.
期刊介绍:
Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.