Abstract
Background
Cementless tibial components have shown improvements in clinical performance compared
to predicate designs, though evidence supporting mid-term performance and fixation
is scarce. The purpose of this study is to determine the mid-term survivorships, revision
rates, and reasons why 3-dimensional printed cementless tibial baseplates (3DTKAs)
failed compared to other cementless as well as cemented tibial baseplates reported
from the American Joint Replacement Registry (AJRR) data.
Methods
All primary total knee arthroplasty (TKA) cases performed in patients 65 years of
age or older within the AJRR from January 2, 2012 through June 30, 2020 were queried.
A total of 28,631 3DTKAs were identified from 428 institutions. These were compared
to all other “aggregated cementless tibia” (n = 7,577) and “aggregated cemented tibia”
(n = 550,133) cases. Centers for Medicare & Medicaid Services data over the same time
period were merged with AJRR data to determine survivorship and patient-timed incident
revision rates per 1,000 years. Failure reasons were tracked during this study period.
Results
At 60 months, Kaplan-Meier implant survivorship was 98.9% (CI 98.7-99.0), 98.3% (CI
97.9-98.6), and 98.4% (CI 98.4-98.5) in the 3DTKA, aggregate cementless, and cemented
knee cohorts, respectively (P < .0001). Patient-timed incident revision rates were 3.11 (CI 2.75-3.53), 3.99 (CI
3.34-4.76), and 3.35 (CI 3.28-3.42) for those cohorts, which corresponds to a revision
rate of 0.31%, 0.40%, and 0.34% per year.
Conclusion
In this analysis, 3DTKA had favorable survivorship and lower revision rates compared
to aggregate cementless and cemented TKAs implanted from the same national database
during the same time period.
Keywords
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Article info
Publication history
Published online: August 04, 2022
Accepted:
July 27,
2022
Received in revised form:
July 15,
2022
Received:
June 9,
2022
Footnotes
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2022.07.020.
Disclaimer: This article is based on reports and/or data from the American Academy of Orthopaedic Surgeons American Joint Replacement Registry. American Academy of Orthopaedic Surgeons is not responsible for and does not necessarily endorse the analysis or conclusions in this article.
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