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- Title
The impact of posterior-stabilized vs. constrained polyethylene liners in revision total knee arthroplasty.
- Authors
Shichman, Ittai; Oakley, Christian T.; Beaton, Geidily; Anil, Utkarsh; Snir, Nimrod; Rozell, Joshua; Meftah, Morteza; Schwarzkopf, Ran
- Abstract
Aim: Posterior stabilized (PS) and varus valgus constrained (VVC) knee polyethylene liners have been shown to confer excellent long-term functional results following revision total knee arthroplasty (rTKA). The purpose of this study was to compare outcomes of patients who underwent rTKA using either a PS or VVC liner. Methods: A retrospective comparative study of 314 rTKA with either PS or VVC liner and a minimum follow-up time of two years was conducted. Patient demographics, complications, readmissions, and re-revision etiology and rates were compared between groups. Kaplan–Meier survivorship analysis was performed to estimate freedom from all-cause revision. Results: Hospital LOS (3.41 ± 2.49 vs. 3.34 ± 1.93 days, p = 0.793) and discharge disposition (p = 0.418) did not significantly differ between groups. At a mean follow-up of 3.55 ± 1.60 years, the proportion of patients undergoing re-revision did not significantly differ (19.1% vs. 18.7%, p = 0.929). In subgroup analysis of re-revision causes, the VVC cohort had superior survival from re-revision due to instability compared to the PS cohort (97.8% vs. 89.4%, p = 0.003). Freedom from re-revision due to aseptic loosening did not significantly differ between groups (85.2% vs. 78.8%, p = 0.436). Improvements in range of motion (ROM) from preoperative to latest follow-up were similar as well. Conclusions: PS and VVC liners confer similar survivorship, complication rates, and overall knee ROM in rTKA. VVC liners were not associated with increased postoperative aseptic loosening and demonstrated superior freedom from re-revision due to instability. Future studies with longer follow-up are warranted to better determine significant differences in clinical outcomes between the two bearing options. Level III evidence: Retrospective Cohort Study.
- Subjects
TOTAL knee replacement; POLYETHYLENE; FEMUR head; SURVIVAL analysis (Biometry); RANGE of motion of joints
- Publication
Archives of Orthopaedic & Trauma Surgery, 2023, Vol 143, Issue 2, p995
- ISSN
0936-8051
- Publication type
Article
- DOI
10.1007/s00402-022-04630-y