OSTEOARTHRITIS
Superior fixation of pegged trabecular metal over screw-fixed pegged porous titanium fiber mesh: A randomized clinical RSA study on cementless tibial components
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(2):108 Acta Orthop. 2011 Apr;82(2):177-86.50 patients were randomized to receive either high-porosity trabecular metal (TM) tibial components or low-porosity titanium pegged porous fiber-metal (Ti) components in the treatment of primary osteoarthritis of the knee. This study was performed to compare the stability of these cementless implants. The results indicated that TM tibial components migrated less than the Ti components at 1 and 2 year post-surgery follow-ups.
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)?
はい = 1
不確実＝0.5
無関係 = 0
いいえ = 0
報告基準評価では、著者が出版物内で試験の方法論的特徴や試験特性を報告する際の透明性を評価します。評価は以下の5つのカテゴリーに分類されます。
3/4
Randomização
3/4
Medidas de resultado
4/4
Inclusão/Exclusão
4/4
Descrição do tratamento
4/4
Estatística
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
Fragility Indexは、重要な所見の解釈を助けるツールで、結果の強さの尺度を提供します。Fragility Indexは、その所見が有意でなくなるために、二項対立の結果に追加する必要がある連続した事象の数を表します。数値が小さいほど弱い所見を表し、数値が大きいほど強い所見を表します。
なぜ今この研究が必要なのですか？
There is currently insufficient evidence regarding the efficacy of high-porosity double-pegged trabecular metal versus low-porosity titanium pegged fiber-metal as a cementless tibial component for patients suffering from primary knee osteoarthritis.
主な研究課題は何ですか？
Does a high-porosity double-pegged trabecular metal component tibial lead to improved fixation as compared to a low-porosity titanium fiber-metal tibial component in patients undergoing intervention for primary knee osteoarthritis, when measured two years post-operatively?
重要な知見は？
- Migration of the trabecular (TM) component was significantly less than the low-porosity titanium component. This result was significant at both the one year (p = .01) and two year follow-up (p = .004).
- AKSS reports of both groups indicated reductions in pain at 2 year follow-up compared to preoperative scores, with 14/22 in the TI group and 17/23 in the TM group, reporting no pain.
最も覚えておくべきことは？
The trabecular metal component was superior to the low-porosity titanium component in terms of total migration, measured two years postoperatively.
それが私の患者ケアにどのように影響するか？
This study provides support for the use of porous tantalum as an alternative to traditional implants. However, the small sample size of the study and the unknown results of longer term follow up should be considered.
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