Evidence map›Paper›PMID 30128685›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019

An optimum prosthesis combination of low-risk total knee arthroplasty options in all five primary categories of design results in a 60% reduction in revision risk: a registry analysis of 482,373 prostheses.

Christopher J Vertullo, Stephen E Graves, Yi Peng, Peter L Lewis

Abstract read
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In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Christopher J VertulloKnee Research Australia, 8-10 Carrara Street, Benowa, QLD, 4217, Australia. Chris.vertullo@icloud.com.ORCID http://orcid.org/0000-0002-8447-8399
Stephen E GravesAustralian Orthopaedic Association National Joint Replacement Registry, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia.ORCID http://orcid.org/0000-0002-1276-2040
Yi PengAustralian Orthopaedic Association National Joint Replacement Registry, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia.ORCID http://orcid.org/0000-0003-0429-1397
Peter L LewisAustralian Orthopaedic Association National Joint Replacement Registry, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia.ORCID http://orcid.org/0000-0003-2641-3754
Australian Orthopaedic Association · AUGriffith University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDecades of innovations in total knee arthroplasty (TKA) design have led to large number of possible prosthesis combinations in regards fixation, posterior stability, bearing mobility, bearing surface, and patella resurfacing, each of which can alter the revision risk. The accumulative effect when the lowest risk combination in each design category, or "Optimum Prosthesis Combination" (OPC) is utilized remains unknown. The purpose of this analysis was to first, identify the OPC and second, to compare the revision risk of a cohort who received the OPC to a cohort who received an Alternative Prosthesis Combination (APC).

methodsNational registry revision risk data for primary TKA for osteoarthritis were obtained from September 1999 to December 2015 for two patient cohorts, those receiving an OPC and those receiving an APC. OPC was defined as TKA with the lowest revision risk option for five primary TKA design categories; fixation, posterior stability, bearing mobility, bearing surface, and patella resurfacing, while APC had one or more higher risk options.

resultsOf the 482,373 included TKA, 42,008 (8.7%) were in the OPC cohort, who received a minimally stabilized, fixed bearing TKA with cross-linked polyethylene with patella resurfacing. Both cohorts had similar demographics. At 10 years, the OPC cohort had a Cumulative Percent Revision of 2.4% (95% CI 2.1, 2.8) compared to 5.5% (95% CI 5.4, 5.6) for the APC cohort. For all patients, revision risk of the APC cohort was higher at all times [151% greater at ≥ 3 years (p < 0.001)]. Loosening/lysis was the most common cause of revision in the ACP cohort (1.1%), while it was the second most common cause in the OPC cohort (0.3%). The increased risk was apparent in all age and gender subgroups, with the highest risk increase seen in males ≥ 65 years.

conclusionsPatients receiving the lowest risk prosthesis design combination or Optimum Prosthesis Combination TKA had a 60% lower revision risk, with similar demographics to the Alternative Prosthesis Combination TKA. LEVEL OF EVIDENCE: III.

Indexed as

Knee ProsthesisProsthesis DesignAgedArthroplasty, Replacement, KneeFemaleHumansMaleRange of Motion, ArticularRegistriesReoperationRiskBenchmarkingDecision makingKnee arthroplastyKnee arthroplasty revisionKnee replacementProsthesis designProsthesis outcomesRegistry data

Identifiers

PMID30128685
OpenAlexW2888623176

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.