Association between fixation type and revision risk in total knee arthroplasty patients aged 65 years and older : a cohort study of 265,877 patients from the Nordic Arthroplasty Register Association 2000–2016

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Association between fixation type and revision risk in total knee arthroplasty patients aged 65 years and older : a cohort study of 265,877 patients from the Nordic Arthroplasty Register Association 2000–2016

Irmola, Tero (författare): University of Tampere

Ponkilainen, Ville (författare): University of Tampere

Mäkelä, Keijo T. (författare): Finnish National Institute for Health and Welfare,Turku University Hospital,The Finnish Arthroplasty Register,University of Turku

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Robertsson, Otto (författare): Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Swedish Knee Arthroplasty Register

W-Dahl, Annette (författare): Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Swedish Knee Arthroplasty Register,Skåne University Hospital

Furnes, Ove (författare): Haukeland University Hospital,University of Bergen,Norwegian Arthroplasty Register

Fenstad, Anne M. (författare): Haukeland University Hospital,Norwegian Arthroplasty Register

Pedersen, Alma B. (författare): Aarhus University Hospital,Danish Knee Arthroplasty Register

Schrøder, Henrik M. (författare): Naestved Hospital

Eskelinen, Antti (författare): University of Tampere

Niemeläinen, Mika J. (författare): University of Tampere

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2020-11-04
2021
Engelska.
Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 92:1, s. 91-96

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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Background and purpose — The population of the Nordic countries is aging and the number of elderly patients undergoing total knee arthroplasty (TKA) is also expected to increase. Reliable fixation methods are essential to avoid revisions. We compared the survival of different TKA fixation concepts with cemented fixation as the gold standard. Patients and methods — We used data from the Nordic Arthroplasty Register Association (NARA) database of 265,877 unconstrained TKAs performed for patients aged ≥ 65 years with primary knee osteoarthritis between 2000 and 2016. Kaplan–Meier (KM) survival analysis with 95% confidence intervals (CI) and the Cox multiple-regression model were used to compare the revision risk of the fixation methods. Results — Cemented fixation was used in 243,166 cases, uncemented in 8,000, hybrid (uncemented femur with cemented tibia) in 14,248, and inverse hybrid (cemented femur with uncemented tibia) fixation in 463 cases. The 10-year KM survivorship (95% CI) of cemented TKAs was 96% (96 − 97), uncemented 94% (94 − 95), hybrid 96% (96 − 96), and inverse hybrid 96% (94 − 99), respectively. Uncemented TKA was associated with increased risk of revision compared with the cemented TKA; the adjusted hazard ratio was 1.3 (95% CI 1.1 − 1.4). Interpretation — Cemented, hybrid, and inverse hybrid TKAs showed 10-year survival rates exceeding 95%. Uncemented fixation was associated with an increased risk of revision in comparison with cemented fixation. As both hybrid and inverse hybrid fixation were used in only a limited number of TKAs, indicating possibility of selection bias in their favor, cemented TKA still remains the gold standard, as it works reliably in the hands of many.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)

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Av författaren/redakt...: Irmola, Tero; Ponkilainen, Vil ...; Mäkelä, Keijo T.; Robertsson, Otto; W-Dahl, Annette; Furnes, Ove; visa fler...; Fenstad, Anne M.; Pedersen, Alma B ...; Schrøder, Henrik ...; Eskelinen, Antti; Niemeläinen, Mik ...; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Ortopedi

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Av lärosätet: Lunds universitet

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