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J Knee Surg 2024; 37(14): 949-958
DOI: 10.1055/a-2376-6889
Original Article

Survivorship of Primary NexGen Knee Replacement: Comparing Cementless Trabecular Metal to Other Designs of Tibial Component

Ayooluwa S. Ayoola
1   Department of Orthopaedic Surgery, Western Michigan School of Medicine Homer Stryker M.D., Kalamazoo, Michigan
,
Michael A. Charters
2   Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan
,
Hamza M. Raja 
2   Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan
,
Luke Weseman 
3   Department of Orthopaedic Surgery, Wayne State University School of Medicine, Detroit, Michigan
,
Peter L. Lewis
4   Department of Orthopaedic Surgery, Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, South Australia
,
Yi Peng
5   Department of Orthopaedic Surgery, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia
,
Wayne Trevor North
2   Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan
› Author Affiliations Funding This project received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
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Abstract

The impact of cementless trabecular metal (TM) implants on implant survivorship are not well delineated. This study compares primary total knee arthroplasty (TKA) revision rates of cemented knee replacements with two cementless knee replacement designs—cementless TM and a non-TM cementless design. Data from a national registry queried TKA procedures performed for osteoarthritis from 1999 to 2020. The risk of revision of Zimmer NexGen TKA using cementless TM, cementless non-TM, and cemented non-TM were compared. Analyses included Kaplan–Meier estimates of survivorship and Cox hazard ratios (HR), stratified by age and gender. Cementless TM components had higher risks of revision compared with cementless non-TM implants (HR = 1.49; p ≤ 0.001). Cementless TM implants showed higher risks of revision compared with cemented non-TM prostheses for the first 2 years (HR = 1.75, p < 0.001). Non-TM prostheses posed equal risk of revision for cementless and cemented fixations (HR = 0.95, p = 0.522). Patients aged 55 to 64 years and 65 to 74 years had a higher risk of revision for cementless TM compared with cementless non-TM (HR = 1.40, p = 0.033 and HR = 1.79, p < 0.001, respectively) and cemented non-TM implants (HR = 1.51, p < 0.001 and HR = 1.54, p < 0.001, respectively). The study shows there is an increased risk of revision with TM cementless implants for patients aged 55 to 74 years. These results do not support the use of TM tibial implants for patients of this age group for primary TKA.

Keywords

arthroplasty - trabecular metal - cemented knee


Publication History

Received: 27 February 2024

Accepted: 30 July 2024

Accepted Manuscript online:
31 July 2024

Article published online:
02 September 2024

© 2024. Thieme. All rights reserved.

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