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Wear and Lysis is the Problem in Modular TKA in the Young OA Patient at 10 Years

  • Symposium: Papers Presented at the Annual Meetings of the Knee Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Most long-term followup studies of younger patients who underwent TKA include a relatively high percentage of rheumatoid patients, whose function and implant durability may differ from those with osteoarthritis (OA).

Questions/purposes

The purpose of this study was to evaluate the minimum 10 year followup of TKA performed in more active patients with OA, using modular tibial components, to determine the durability of that construct. Specifically, we determined (1) survivorship; (2) revision rates; (3) functional scores; and (4) rates of radiographic failure at a minimum 10 year followup.

Methods

We retrospectively reviewed 59 patients (67 knees) with OA who underwent primary total knee arthroplasty with posterior cruciate retaining (27%) or posterior cruciate substituting (73%) components which had modular tibial trays. Patients were evaluated clinically for need of revision and Knee Society, SF-36 and WOMAC scores as well as UCLA and Tegner activity scores. Radiographs were evaluated for loosening and osteolysis. The minimum followup of living patients was 10 years (mean, 12.4 years; range, 10 to 18.4 years). Ten patients (11 knees) died; two patients (2 knees) were lost to followup.

Results

Ten patients (11 knees; 16%) had revisions for aseptic loosening and/or osteolysis. Thirty-one patients (65%) were still performing moderate labor or sports activities. The average UCLA score was 5.5 (range, 2–9). No nonrevised knee demonstrated radiographic loosening.

Conclusion

Most patients in this active patient population continued to have acceptable function although 16% underwent revision for wear and/or osteolysis. Isolated tibial insert exchange alone was performed in four of the 11 (36%) revised knees. These data should provide comparison for total knee arthroplasties performed in younger patients with newer designs and newer bearing materials.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgements

We thank Yubo Gao, PhD for his assistance with statistical methods for this study.

Author information

Authors and Affiliations

  1. University of Iowa, 200 Hawkins Dr., UIHC, 01029 JPP, Iowa City, IA, 52242, USA

    Andrew N. Odland BS, John J. Callaghan MD, Steve S. Liu MD & Christopher W. Wells BA

  2. VA Medical Center, Iowa City, IA, USA

    John J. Callaghan MD

Authors
  1. Andrew N. Odland BS
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  2. John J. Callaghan MD
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  3. Steve S. Liu MD
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  4. Christopher W. Wells BA
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Corresponding author

Correspondence to John J. Callaghan MD.

Additional information

One of the authors (JJC) has received royalties from DePuy, Inc.

Each author certifies that his institution has approved the reporting of these cases, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participating in the study was obtained.

This work was performed at the University of Iowa.

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Odland, A.N., Callaghan, J.J., Liu, S.S. et al. Wear and Lysis is the Problem in Modular TKA in the Young OA Patient at 10 Years. Clin Orthop Relat Res 469, 41–47 (2011). https://doi.org/10.1007/s11999-010-1429-y

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  • DOI: https://doi.org/10.1007/s11999-010-1429-y

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