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Orthopaedic Proceedings
Vol. 102-B, Issue SUPP_9 | Pages 67 - 67
1 Oct 2020
Lachiewicz PF Vovos TJ Steele JR Wellman SS
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Background

There are case series of debonding of the ATTUNE® tibial component introduced in 2013. We studied the early clinical results of this total knee arthroplasty (TKA) and compared it to other designs at one hospital.

Methods

This is a retrospective study of 223 consecutive, non-randomized, cemented fixed-bearing posterior-stabilized ATTUNE® TKAs at one hospital by 5 surgeons from 2013 through 2017. We excluded 4 knees with early infection and 53 with follow-up less than 6 months. Of 166 TKAs reviewed, the mean patient age was 63.8 years, mean BMI 32, and mean follow-up 25 months. We compared this to a “control” cohort of 511 TKAs of other manufacturers performed at the same hospital. The endpoints were revision performed and revision pending.


Introduction

There is insufficient data on the trends of anticoagulation after total knee arthroplasty (TKA) in the USA, and the efficacy and safety of rivaroxaban, beyond randomized clinical trials and small cohort studies.

Patients and Methods

Using the Truven Health MarketScan database, we retrospectively evaluated new anticoagulation prescriptions after elective TKA from 2010 to 2015. The frequency of deep vein thrombosis (DVT), pulmonary embolism (PE), and adverse events, within 90 days, were then evaluated in 24,856 new users of warfarin and 21,398 new users of rivaroxaban in commercially insured patients (COM), and 15,483 new users of warfarin and 8,997 new users of rivaroxaban in Medicare supplement patients (MED). Data was analyzed by odds ratios using logistic regression models with stabilized inverse probability treatment weighting.


Introduction

Polyethylene wear and osteolysis remain a concern with the use of modular, fixed bearing total knee arthroplasty (TKA). A variety of highly cross-linked polyethylenes (XLPs) have been introduced to address this problem, but there are few data on the results and complications of this polyethylene in posterior-stabilized knee prosthesis. We have previously reported an interim analysis of a study comparing polyethylene tibial liners.

Methods

This is a prospective randomized study of one modular posterior-stabilized total knee arthroplasty by a single surgeon. 265 patients (329 knees) were randomized to receive a standard compression molded liner (SP) or a highly cross-linked (6.5 CGy electron-beam irradiated and remelted) polyethylene liner (XLP). Patients were evaluated clinically using the classic Knee Society scores, LEAS score, presence of a knee effusion, and by standard radiographs for radiolucent lines and osteolytic lesions. The analysis was performed at a mean of 6 years (range, 2–11 years).