Skip to main content
SpringerLink
Log in

The Survival of Total Knee Arthroplasty: Current Data from Registries on Tribology

Review Article

  • Global Tribology Summit
  • Published:
HSS Journal ®

Abstract

Background

Polyethylene (PE) wear is a major contributor to implant loosening following total knee arthroplasty (TKA), and advanced bearings in TKA are being investigated with hopes of reducing or eliminate wear-related loosening. Currently, information on knee tribology is available from national joint registries and may be the best tools to evaluate the efficacy and safety of design innovations in joint arthroplasty.

Questions/Purposes

We performed a review of national joint registries trying to answer the following questions: “Which is the main factor directly related to revisions rate in TKA?” and “Are there new bearing options better than conventional ones?”

Methods

A review was performed of all published annual reports of National Joint Registers, as well as of the literature. The search was carried out using and comparing the National Joint Registers.

Results

Current data from registries for total knee arthroplasty indicates that age is the major factor affecting the outcome of primary total knee replacement. The 10-year cumulative revision rate for non-cross-linked PE was 5.8% and for XLPE it was 3.5%. The effect of cross-linked polyethylene was more evident in the younger patients. The survival of the oxidized zirconium (OxZr) femoral component appears better when compared to a similar age group of patients with conventional group of prostheses. Our review suggests that the revision rates are half for the OxZr components compared to conventional CoCr femoral components.

Conclusions

Age is the most relevant single factor related to revision rate. Cross-linked PE has a statistical lower revision rate at 10 years compared to conventional PE and, in the OxZr group, the revision rate is 2 times lower than Co-Cr in the same group of age.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Australian Orthopaedic Association National Joint Replacement Registry. Annual Report. Adelaide:AOA; 2014. Accessed 29 Sep 2015. https://aoanjrr.dmac.adelaide.edu.au/documents/10180/172286/Annual%20Report%202014

  2. Holland P, Santini AJ, Davidson JS, Pope JA. Five year survival analysis of an oxidised zirconium total knee arthroplasty. Knee. 2013; 20(6): 384-387.

    Article  PubMed  Google Scholar 

  3. Hofer JK, Ezzet KA. A minimum 5-year follow-up of an oxidized zirconium femoral prosthesis used for total knee arthroplasty. Knee. 2014; 21(1): 168-171.

    Article  PubMed  Google Scholar 

  4. Hui C, Salmon L, Maeno S, Roe J, Walsh W, Pinczewski L. Five-year comparison of oxidized zirconium and cobalt-chromium femoral components in total knee arthroplasty: a randomized controlled trial. J Bone Joint Surg Am. 2011; 93(7): 624-630.

    Article  PubMed  Google Scholar 

  5. Inacio MC, Cafri G, Paxton EW, Kurtz SM, Namba RS. Alternative bearings in total knee arthroplasty: risk of early revision compared to traditional bearings: an analysis of 62,177 primary cases. Acta Orthop. 2013; 84(2): 145-152.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Innocenti M, Civinini R, Carulli C, Villano M, Linari S, Morfini M. A modular total knee arthroplasty in haemophilic arthropathy. Knee. 2007; 14(4): 264-268.

    Article  CAS  PubMed  Google Scholar 

  7. Innocenti M, Matassi F, Carulli C, Nistri L, Civinini R. Oxidized zirconium femoral component for TKA: a follow-up note of a previous report at a minimum of 10 years. Knee. 2014; 21(4): 858-861.

    Article  PubMed  Google Scholar 

  8. Innocenti M, Civinini R, Carulli C, Matassi F, Villano M. The 5-year Results of an Oxidized Zirconium Femoral Component for TKA. ClinOrthopRelat Res. 2010; 468(5): 1258-1263.

    Google Scholar 

  9. Kim YH, Park JW, Kim JS. Comparison of the Genesis II total knee replacement with oxidised zirconium and cobalt-chromium femoral components in the same patients: a prospective, double-blind, randomised controlled study. J Bone Joint Surg (Br). 2012; 94(9): 1221-1227.

    Article  Google Scholar 

  10. Labek G, Thaler M, Janda W, Agreiter M, Stöckl B. Revision rates after total joint replacement: cumulative results from worldwide joint register datasets. J Bone Joint Surg (Br). 2011; 93(3): 293-297.

    Article  CAS  Google Scholar 

  11. Lachiewicz PF, Soileau ES. Is There a Benefit to Highly Crosslinked Polyethylene in Posterior-stabilized Total Knee Arthroplasty? ClinOrthopRelat Res: A Randomized Trial; 2015.

    Google Scholar 

  12. Laskin RS. An oxidized Zr ceramic surfaced femoral component for total knee arthroplasty. ClinOrthopRelat Res. 2003; 416: 191-196.

    Google Scholar 

  13. National Joint Registry for England, Wales and Northern Ireland - 11th Annual Report 2014. NJR; 2014. Accessed 29 Sep 2015. http://www.njrcentre.org.uk/njrcentre/Portals/0/Documents/England/Reports/11th_annual_report/NJR%2011th%20Annual%20Report%202014.pdf

  14. Pabinger C, Berghold A, Boehler N, Labek G. Revision rates after knee replacement. Cumulative results from worldwide clinical studies versus joint registers. Osteoarthritis Cartilage. 2013; 21(2): 263-268.

    Article  CAS  PubMed  Google Scholar 

  15. Pabinger C, Bridgens A, Berghold A, Wurzer P, Boehler N, Labek G. Quality of outcome data in total hip arthroplasty: comparison of registry data and worldwide non-registry studies from 5 decades. Hip Int. 2015; 20.

  16. Park DH, Leong J, Palmer SJ. Total knee arthroplasty with an oxidised zirconium femoral component: a 5-year follow-up study. J OrthopSurg (Hong Kong). 2014; 22(1): 75-79.

    Article  Google Scholar 

  17. Quality of Publications regarding the Outcome of Revision Rate after Arthroplasty. Interim Report of the QoLA Project. EFORT-EAR; 2010. Accessed 29 Sep 2015. http://www.ear.efort.org/downloads/EAR-EFORT%20QoLA%20Project.pdf

  18. Ranstam J, Kärrholm J, Pulkkinen P, et al. Statistical analysis of arthroplasty data. I. Introduction and background. Acta Orthop. 2011; 82(3): 253-257.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Ranstam J, Robertsson O. Statistical analysis of arthroplasty register data. Acta Orthop. 2010; 81(1): 10-14.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Ranstam J, Kärrholm J, Pulkkinen P, et al. Statistical analysis of arthroplasty data. II. Guidelines. Acta Orthop. 2011; 82(3): 258-267.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Steiger RN, Muratoglu O, Lorimer M, Cuthbert AR, Graves SE. Lower prosthesis-specific 10-year revision rate with crosslinked than with non-crosslinked polyethylene in primary total knee arthroplasty. Acta Orthop. 2015; 28: 1-7.

    Google Scholar 

  22. Swedish Knee Arthroplasty Register - Annual Report 2014. SKAR; 2014. Accessed 29 Sep 2015. http://myknee.se/pdf/SKAR2014_Eng_1.1.pdf

  23. The New Zeland Joint Registry 15 Year Report. NZOA; 2014. Accessed 29 Sep 2015. http://www.nzoa.org.nz/system/files/NZJR2014Report.pdf

Download references

Author information

Authors and Affiliations

  1. Department of Surgical Science and Translational Medicine, Orthopedic Clinic, University of Florence, Largo P. Palagi 1, 50139, Florence, Italy

    Roberto Civinini MD, Christian Carulli MD, Fabrizio Matassi MD, Andrea Cozzi Lepri MD, Luigi Sirleo MD & Massimo Innocenti MD

Authors
  1. Roberto Civinini MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christian Carulli MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fabrizio Matassi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrea Cozzi Lepri MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luigi Sirleo MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Massimo Innocenti MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Roberto Civinini MD.

Ethics declarations

Conflict of Interest

Fabrizio Matassi, MD, Christian Carulli, MD, Luigi Sirleo, MD, and Andrea Cozzi Lepri, MD, have declared that they have no conflict of interest. Roberto Civinini, MD, reports personal fees from Smith & Nephew, outside the work. Innocenti, MD, reports personal fees from Smith & Nephew, outside the work.

Human/Animal Rights

This article does not contain any studies with human or animal subjects performed by the any of the authors.

Informed Consent

N/A

Required Author Forms

Disclosure forms provided by the authors are available with the online version of this article.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(PDF 1225 kb)

ESM 2

(PDF 1225 kb)

ESM 3

(PDF 1225 kb)

ESM 4

(PDF 1225 kb)

ESM 5

(PDF 1225 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Civinini, R., Carulli, C., Matassi, F. et al. The Survival of Total Knee Arthroplasty: Current Data from Registries on Tribology. HSS Jrnl 13, 28–31 (2017). https://doi.org/10.1007/s11420-016-9513-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11420-016-9513-9

Keywords

Search

Navigation