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)?
Sim = 1
Incerto = 0,5
Não relevante = 0
Não = 0
A Avaliação dos Critérios de Relato avalia a transparência com que os autores relatam as caraterísticas metodológicas e do ensaio na publicação. A avaliação está dividida em cinco categorias que são apresentadas de seguida.
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
O Índice de Fragilidade é uma ferramenta que auxilia na interpretação de achados significativos, fornecendo uma medida de força para um resultado. O Índice de Fragilidade representa o número de eventos consecutivos que precisam de ser adicionados a um resultado dicotómico para que o resultado deixe de ser significativo. Um número pequeno representa um resultado mais fraco e um número grande representa um resultado mais forte.
Porque é que este estudo era necessário agora?
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 a principal questão de investigação?
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).
De que é que me devo lembrar mais?
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.
Como é que isto afectará o tratamento dos meus doentes?
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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