Carl Christian Holkgaard Burvil, Karina Nørgaard Linde, Maiken Stilling, Torben Bæk Hansen, Jesper Dalsgaard, Søren Rytter, Daan Koppens, Emil Toft Petersen
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Tibial and femoral component migration was assessed using static radiostereometric analysis, with the first stereo-radiograph taken supine on the first postoperative day (baseline) and again at 3-, 12-, and 24-month follow-up. Tibial and femoral component migration was evaluated in six degrees of freedom and as maximum total point motion (MTPM).</p><p><strong>Results: </strong>At the 12-month follow-up, the mean difference in tibial component MTPM was 0.04 mm (95% confidence interval [CI]: -0.21 to 0.28). The mean MTPM was 0.81 mm (95% CI: 0.64-0.99) in the MC group and 0.85 mm (95% CI: 0.68-1.03) in the CR group. Signed migrations were similar for the MC and the CR group throughout 24 months of follow-up (p > 0.09). At the 12-month follow-up, the mean difference in femoral component MTPM was 0.18 mm (95% CI: -0.17 to 0.53). The mean MTPM was 1.08 mm (95% CI: 0.83-1.32) in the MC group and 1.26 mm (95% CI: 1.01-1.51) in the CR group. The femoral components with MC insert had 0.18 mm (95% CI: 0.03-0.32) and 0.20 mm (95% CI: 0.01-0.39) more lateral migration at 3- and 12-month follow-up, respectively. At the 24-month follow-up, there was no statistically significant differences in migration for either translations, rotations or MTPM.</p><p><strong>Conclusions: </strong>Both tibial and femoral components had similar and acceptable fixation regardless of the type of polyethylene insert.</p><p><strong>Level of evidence: </strong>Level I.</p>","PeriodicalId":520702,"journal":{"name":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Similar fixation of total knee arthroplasty components with medial congruent and cruciate retaining polyethylene inserts. A randomised double-blinded controlled radiostereometry trial with 24 months of follow-up.\",\"authors\":\"Carl Christian Holkgaard Burvil, Karina Nørgaard Linde, Maiken Stilling, Torben Bæk Hansen, Jesper Dalsgaard, Søren Rytter, Daan Koppens, Emil Toft Petersen\",\"doi\":\"10.1002/ksa.12753\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To assess the influence of a higher constraint medial congruent (MC) versus a cruciate retaining (CR) (gold standard) polyethylene insert on the migration of cemented tibial and femoral components of the Persona Total Knee System. High-constraint inserts may increase forces on components and potentially affect implant migration and long-term fixation.</p><p><strong>Methods: </strong>A cohort of 66 patients with primary knee osteoarthritis received a cemented Persona total knee arthroplasty and were randomised to either an MC or a CR polyethylene insert. Tibial and femoral component migration was assessed using static radiostereometric analysis, with the first stereo-radiograph taken supine on the first postoperative day (baseline) and again at 3-, 12-, and 24-month follow-up. Tibial and femoral component migration was evaluated in six degrees of freedom and as maximum total point motion (MTPM).</p><p><strong>Results: </strong>At the 12-month follow-up, the mean difference in tibial component MTPM was 0.04 mm (95% confidence interval [CI]: -0.21 to 0.28). The mean MTPM was 0.81 mm (95% CI: 0.64-0.99) in the MC group and 0.85 mm (95% CI: 0.68-1.03) in the CR group. Signed migrations were similar for the MC and the CR group throughout 24 months of follow-up (p > 0.09). At the 12-month follow-up, the mean difference in femoral component MTPM was 0.18 mm (95% CI: -0.17 to 0.53). The mean MTPM was 1.08 mm (95% CI: 0.83-1.32) in the MC group and 1.26 mm (95% CI: 1.01-1.51) in the CR group. The femoral components with MC insert had 0.18 mm (95% CI: 0.03-0.32) and 0.20 mm (95% CI: 0.01-0.39) more lateral migration at 3- and 12-month follow-up, respectively. At the 24-month follow-up, there was no statistically significant differences in migration for either translations, rotations or MTPM.</p><p><strong>Conclusions: </strong>Both tibial and femoral components had similar and acceptable fixation regardless of the type of polyethylene insert.</p><p><strong>Level of evidence: </strong>Level I.</p>\",\"PeriodicalId\":520702,\"journal\":{\"name\":\"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-07-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12753\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/ksa.12753","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的：评估高约束内侧一致性（MC）与十字保留（CR）（金标准）聚乙烯假体对假面全膝关节系统骨水泥胫骨和股骨假体迁移的影响。高约束的植入物可能会增加对构件的作用力，并可能影响植入物的迁移和长期固定。方法：66例原发性膝骨关节炎患者接受骨水泥假人全膝关节置换术，随机分为MC或CR聚乙烯植入物组。使用静态放射立体分析评估胫骨和股骨假体的迁移，在术后第一天（基线）第一次仰卧位立体x线片，并在3个月、12个月和24个月的随访中再次拍摄。胫骨和股骨假体的移动以6个自由度和最大总点运动（MTPM）进行评估。结果：在12个月的随访中，胫骨成分MTPM的平均差异为0.04 mm（95%可信区间[CI]: -0.21至0.28）。MC组平均MTPM为0.81 mm (95% CI: 0.64-0.99)， CR组平均MTPM为0.85 mm （95% CI: 0.68-1.03）。在24个月的随访中，MC组和CR组的签名迁移相似（p < 0.09）。在12个月的随访中，股骨成分MTPM的平均差异为0.18 mm （95% CI: -0.17至0.53）。MC组平均MTPM为1.08 mm (95% CI: 0.83-1.32)， CR组平均MTPM为1.26 mm （95% CI: 1.01-1.51）。在3个月和12个月的随访中，带MC植入物的股骨假体的外侧偏移量分别增加了0.18 mm （95% CI: 0.03-0.32）和0.20 mm （95% CI: 0.01-0.39）。在24个月的随访中，无论是平移、旋转还是MTPM，在迁移方面都没有统计学上的显著差异。结论：无论何种聚乙烯内固定物，胫骨和股骨假体均具有相似且可接受的固定。证据等级：一级。
Similar fixation of total knee arthroplasty components with medial congruent and cruciate retaining polyethylene inserts. A randomised double-blinded controlled radiostereometry trial with 24 months of follow-up.
Purpose: To assess the influence of a higher constraint medial congruent (MC) versus a cruciate retaining (CR) (gold standard) polyethylene insert on the migration of cemented tibial and femoral components of the Persona Total Knee System. High-constraint inserts may increase forces on components and potentially affect implant migration and long-term fixation.
Methods: A cohort of 66 patients with primary knee osteoarthritis received a cemented Persona total knee arthroplasty and were randomised to either an MC or a CR polyethylene insert. Tibial and femoral component migration was assessed using static radiostereometric analysis, with the first stereo-radiograph taken supine on the first postoperative day (baseline) and again at 3-, 12-, and 24-month follow-up. Tibial and femoral component migration was evaluated in six degrees of freedom and as maximum total point motion (MTPM).
Results: At the 12-month follow-up, the mean difference in tibial component MTPM was 0.04 mm (95% confidence interval [CI]: -0.21 to 0.28). The mean MTPM was 0.81 mm (95% CI: 0.64-0.99) in the MC group and 0.85 mm (95% CI: 0.68-1.03) in the CR group. Signed migrations were similar for the MC and the CR group throughout 24 months of follow-up (p > 0.09). At the 12-month follow-up, the mean difference in femoral component MTPM was 0.18 mm (95% CI: -0.17 to 0.53). The mean MTPM was 1.08 mm (95% CI: 0.83-1.32) in the MC group and 1.26 mm (95% CI: 1.01-1.51) in the CR group. The femoral components with MC insert had 0.18 mm (95% CI: 0.03-0.32) and 0.20 mm (95% CI: 0.01-0.39) more lateral migration at 3- and 12-month follow-up, respectively. At the 24-month follow-up, there was no statistically significant differences in migration for either translations, rotations or MTPM.
Conclusions: Both tibial and femoral components had similar and acceptable fixation regardless of the type of polyethylene insert.
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