DOES GENDER SPECIFIC IMPLANT IMPROVE FUNCTION AND PATIENT SATISFACTION IN TOTAL KNEE ARTHROPLASTY?

Abstract

Introduction: Women have gender specific shape of the distal femur. To fit these gender characteristics, gender specific femoral implants were developed for total knee arthroplasty (TKA). We aimed to compare

1. objective and subjective functional improvement;

2. patient satisfaction and preference and

3. cost-utility ratio after gender specific TKA or standard component implanted on the same women.

Materials and Methods: 30 women (60 knees) operated on successively (6 months in between) for a bilateral TKA between March 2006 and March 2008 by the same surgeon were included in this prospective study. The same surgical protocol and the same post-operative management protocol were applied for both sides. Mean age was 67±3 and mean BMI 26±4 Kg/m². At a minimum follow-up of one year, evaluation objective and subjective functional improvement, patient satisfaction and preference and cost-utility analysis were performed double blind.

Results: Knee Society knee score and Knee Osteoarthritis Outcome Score (KOOS) improvements were comparable in both groups. However, 75% of the women preferred their gender TKA (p< 0.001). 68% of the women described less crepitus or anterior knee bothering after gender TKA (p=0.003) and 64% had faster recovery with the gender implant (p< 0.001). The cost-utility analysis was favorable for the gender knee.

Discussion: No objective or subjective superiority in terms of functional improvement was shown with gender specific implants at this short-term follow-up. However significant differences in terms of patient satisfaction and preference and a favorable cost-utility analysis were observed. These results should now be confirmed at longer-follow-up. Despite comparative functional improvement, patient satisfaction and preference were higher for the side implanted with a gender specific TKA in this prospective comparative study.