Ten-year outcomes of a nitrided Ti-6Al-4V titanium alloy fixed-bearing total knee replacement with a highly crosslinked polyethylene-bearing in patients with metal allergy.
Allergy
Hypersensitivity-friendly implants
Metal hypersensitivity
Titanium
Total knee replacement
Journal
The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
18
05
2020
revised:
24
07
2020
accepted:
04
08
2020
pubmed:
4
10
2020
medline:
15
4
2021
entrez:
3
10
2020
Statut:
ppublish
Résumé
Metal hypersensitivity in patients with a total knee arthroplasty (TKA) is a rare condition and a very controversial topic. Despite the lack of data concerning the real effective impact of allergy on TKA failures, most of the manufactures offer the choice of 'non-allergenic' implants both for primary and revision TKA, some of which provide the same designs and surgical techniques as the conventional ones. Only a few studies are available on outcomes on these 'hypersensitivity-friendly' implants and even fewer specifically on allergic patients with a mid- to long-term follow-up. Between 2007 and 2015, we enrolled 72 patients (57 females, 15 males), who underwent TKA treated with a non-allergenic posterior-stabilized (PS) total knee implant for a declared and proven metal allergy. Patients were followed clinically and radiographically for a mean 10 years of follow-up. With revision as an endpoint the Kaplan-Meier survival estimate showed a survival rate of 97.2% at five years and 95.1% at 10 years. Significant improvements in range of motion (ROM), Knee Society Scoring (KSS) and Hospital for Special Surgery (HSS) knee scores were registered at final follow-up (P < 0.0001). At final follow-up validated Patient-Reported Outcome Measures (PROMs) showed the following scores: Oxford Knee Score (OKS) 42.1, EQ5D 0.80, EQ VAS 80.1, Forgotten Joint Score 71.2. This nitrided Ti-6Al-4V titanium alloy fixed-bearing total knee replacement with a highly crosslinked polyethylene-bearing showed interesting results and survival rates in patients with metal allergy at mid- to long-term follow-up.
Sections du résumé
BACKGROUND
BACKGROUND
Metal hypersensitivity in patients with a total knee arthroplasty (TKA) is a rare condition and a very controversial topic. Despite the lack of data concerning the real effective impact of allergy on TKA failures, most of the manufactures offer the choice of 'non-allergenic' implants both for primary and revision TKA, some of which provide the same designs and surgical techniques as the conventional ones. Only a few studies are available on outcomes on these 'hypersensitivity-friendly' implants and even fewer specifically on allergic patients with a mid- to long-term follow-up.
METHODS
METHODS
Between 2007 and 2015, we enrolled 72 patients (57 females, 15 males), who underwent TKA treated with a non-allergenic posterior-stabilized (PS) total knee implant for a declared and proven metal allergy. Patients were followed clinically and radiographically for a mean 10 years of follow-up.
RESULTS
RESULTS
With revision as an endpoint the Kaplan-Meier survival estimate showed a survival rate of 97.2% at five years and 95.1% at 10 years. Significant improvements in range of motion (ROM), Knee Society Scoring (KSS) and Hospital for Special Surgery (HSS) knee scores were registered at final follow-up (P < 0.0001). At final follow-up validated Patient-Reported Outcome Measures (PROMs) showed the following scores: Oxford Knee Score (OKS) 42.1, EQ5D 0.80, EQ VAS 80.1, Forgotten Joint Score 71.2.
CONCLUSIONS
CONCLUSIONS
This nitrided Ti-6Al-4V titanium alloy fixed-bearing total knee replacement with a highly crosslinked polyethylene-bearing showed interesting results and survival rates in patients with metal allergy at mid- to long-term follow-up.
Identifiants
pubmed: 33010769
pii: S0968-0160(20)30294-5
doi: 10.1016/j.knee.2020.08.007
pii:
doi:
Substances chimiques
Alloys
0
Metals
0
titanium alloy (TiAl6V4)
12743-70-3
Polyethylene
9002-88-4
Titanium
D1JT611TNE
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1519-1524Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors have no conflicts of interest to disclose.