AAOS2017: Clinical outcome and survivorship of HXLPE vs. conventional PE inserts in TKA

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
CONFERENCE ACE REPORTS
This ACE Report is a summary of a conference presentation or abstract. The information provided has limited the ability to provide an accurate assessment of the risk of bias or the overall quality. Please interpret the results with caution as trials may be in progress and select results may have been presented.
Synopsis
396 patients scheduled for total knee arthroplasty were randomized to receive either a highly crosslinked polyethylene insert or conventional polyethylene insert. Patients were followed for an average of 5 years (2-8 years) and evaluated for clinical outcomes and for rates of survivorship free of revision due to aseptic loosening, revision due to any reason, and reoperation for any reason. No significant differences Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
The majority of trials evaluating the use of highly cross-linked polyethylene have been completed in total hip arthroplasty, demonstrating its efficacy and its ability to potentially improve long-term survivorship. There is interest in the use of highly cross-linked polyethylene in total knee arthroplasty but few randomized trials have evaluated its long-term efficacy. This study sought to compare clinical outcomes, survivorship, and complications between highly crosslinked polyethylene and conventional polyethylene over a 5-year follow-up.
What was the principal research question?
In total knee arthroplasty, is there any significant difference in clinical outcome, survivorship, or incidence of complications between cases completed with highly crosslinked polyethylene and conventional polyethylene inserts?
Population: 396 patients, 21-85 years of age, scheduled for primary total knee arthroplasty due to osteoarthritis, posttraumatic arthritis, or avascular necrosis. All cases were performed with the same cemented, posterior-stabilized fixed-bearing total knee system with patellar resurfacing.
Intervention: HXLPE group: Patients received a highly crosslinked polyethylene insert. (n=202)
Comparison: Conventional PE group: Patients received a conventional polyethylene insert. (n=194)
Outcomes: Clinical scores included the Knee Society Score (KSS) and the Short Form 12-Item General Health Survey (SF-12). Rates of survivorship free of revision due to aseptic loosening, revision for any reason, and reoperation for any reason
Methods: RCT
Time: Mean follow-up was 5 years (Range: 2-8 years).
What were the important findings?
CONTENT IS LOCKED
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.
Dr. Ian Weber
April 2, 2017
Orthopaedic Surgeon - United States
Difference won't become apparent till greater than 10 years
Ponky Firer
April 5, 2017
Orthopaedic Surgeon - SOUTH AFRICA
This is a study of very little value. The numbers are extremely small. The follow up so short wrt the expected life span that the only comment one can make is that the HXLPE doesn't have early catastrophic failure. A study of more significant numbers longer than 10-15yrs may be of more value.
Dr. Jorgen Hellman
April 6, 2017
Orthopaedic Surgeon - Australia
I would have though 5 years is short term, not mid term!