Mid-term migration of the Triathlon versus Duracon total knee systems .
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2016;4(20):1 Acta Orthop. 2016 Jun;87(3):262-760 patients with knee osteoarthritis and scheduled for total knee arthroplasty were randomized to receive either a newer-generation Triathlon total knee system, or older-generation Duracon total knee system. The purpose of this study was to compare tibial component stability between groups at short- and mid-term follow-up. Three-dimensional translation and rotation of the component were assessed using radiostereometric analysis. After 5 years, significant difference between groups was only observed in varus-valgus rotation.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sì = 1
Incerto = 0,5
Non rilevante = 0
No = 0
La valutazione dei criteri di segnalazione valuta la trasparenza con cui gli autori riportano le caratteristiche metodologiche e sperimentali dello studio all'interno della pubblicazione. La valutazione è suddivisa in cinque categorie che vengono presentate di seguito.
2/4
Aleatorización
3/4
Medición de resultados
2/4
Inclusión / exclusión
0/4
Descripción de la terapia
4/4
Estadísticas
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
L'Indice di Fragilità è uno strumento che aiuta l'interpretazione dei risultati significativi, fornendo una misura della forza di un risultato. L'Indice di Fragilità rappresenta il numero di eventi consecutivi che devono essere aggiunti a un risultato dicotomico per rendere il risultato non più significativo. Un numero piccolo rappresenta un risultato più debole, mentre un numero grande rappresenta un risultato più forte.
Perché questo studio era necessario ora?
The evolution of prostheses for total knee arthroplasty is continuously ongoing. Newer-generation implants are typically released and phased into clinical practice, ultimately replacing routine use of earlier-generation implants over many years. Within this process, careful consideration of long-term outcome of new implants is crucial to ensure patients are not experiencing worse stability and survivorship compared to older implants with proven track records.
Qual era la domanda di ricerca principale?
In total knee arthroplasty, was there any significant difference in radiostereometrically-assessed micromotion of the tibial component between the Triathlon and Duracon cemented knee systems over 5-year follow-up?
- No significant differences between the Duracon and Triathlon groups were observed after 5 years in medial-lateral translation (-0.34+/-1.26 vs. -0.33+/-0.46mm; p=1.0), caudal-cranial translation (-0.5+/-0.51 vs. 0.1+/-0.27mm; p=0.2), or posterior-anterior translation (-0.33+/-1.22 vs. 0.18+/-0.59; p=0.1).
- Overall, mean MTPM after 5 years did not significantly differ between the Duracon group (1.10+/-1.21) and the Triathlon group (0.66+/-0.38)
- No significant differences between the Duracon and Triathlon groups were observed after 5 years in anterior-posterior tilt (0.10+/-0.38 vs. -0.9+/-0.31deg; p=0.1) or internal-external rotation (-0.19+/-0.64 vs. -0.09+/-0.31deg; p=0.5). A significant difference was observed between groups in varus-valgus rotation of the component after 5 years, with 0.18deg (+/-0.48) varus rotation in the Duracon group versus 0.09deg (+/-0.28) valgus rotation in the Triathlon group.
- Continuous migration of the tibial component between years 1 and 2 was observed in 7/24 patients of the Duracon group and 5/26 patients of the Triathlon group.
- Continuous migration of the tibial component between years 2 and 5 was observed in 6/21 patients of the Duracon group and 3/21 patients of the Triathlon group (p=0.2).
Che cosa devo ricordare di più?
In total knee arthroplasty, 5-year maximum total point motion of the tibial component did not significantly differ between patients treated with a Triathlon or Duracon prosthesis. A similar number of patients between groups throughout follow-up demonstrated MTPM values exceeding the thresholds set by the current study as indicative of continuous migration.
Come influenzerà l'assistenza ai miei pazienti?
The results of this study suggest that the newer-generation Triathlon total knee system has a similar mid-term migration profile to that of the predecessor-generation Duracon total knee system. Continued follow-up is necessary to determine if the migration profiles of these two systems remain similar into the long-term.
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