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Comparison of postoperative knee flexion and patient satisfaction between newly and conventionally designed medial pivot total knee arthroplasty: a 5-year follow-up matched cohort study

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The medial pivot total knee arthroplasty (TKA) has good patients’ satisfaction; however, there is likely the restriction of postoperative knee flexion. The 2nd generation medial pivot TKA prosthesis was designed to improve postoperative knee flexion. This study aimed to compare the clinical outcomes and patient satisfaction between the 2nd generation and 1st generation medial pivot TKA prostheses.

Materials and methods

We conducted a retrospective study of 472 consecutive TKAs, performed using either the 2nd generation (EVOLUTION™), having smaller posterior femoral condyle and asymmetrical tibial tray, or 1st generation (ADVANCE™) prosthesis. The use of each system was historically determined. Patient age, sex and body mass index were matched between the two groups, with 157 cases ultimately included in each group. Measured clinical outcomes included: knee range of motion, the Knee Society Score, the rate of re-operation, and radiological parameters. Patient satisfaction was evaluated using the 12-item Forgotten Joint Score (FJS-12).

Results

The average follow-up period was 5.0 (3.7–6.3) years for the 2nd generation group and 8.7 (6.1–12.8) years for the 1st generation group (p < 0.01). The postoperative knee flexion range was 127° (80°–140°) for the 2nd generation and 118° (90°–135°) for the 1st generation at final follow-up (p < 0.01). On multivariate regression analysis, use of the 2nd generation prosthesis predicted greater postoperative knee flexion. The average FJS-12 score was 64 (0–100) for the 2nd generation and mean 57 (0–100) for the 1st generation (p < 0.01). Other clinical outcomes were similar between the two groups.

Conclusions

Compared to the 1st generation, the 2nd generation medial pivot prosthesis provides greater postoperative knee flexion and patient satisfaction.

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Acknowledgements

We appreciate the contributions from all group members in the medical stuff of Osaka City University and Tanabe Central Hospital.

Funding

This study was not supported by any funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Hideki Ueyama, Yukihide Minoda, Nobuo Yamamoto & Hiroaki Nakamura

  2. Department of Orthopedic Surgery, Tanabe Central Hospital, 147 Minamishinmachi, Tanabe city, Wakayama, 646-0042, Japan

    Hideki Ueyama, Narihiro Kanemoto & Yoshiki Taniguchi

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  1. Hideki Ueyama
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  2. Narihiro Kanemoto
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Correspondence to Hideki Ueyama.

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Ueyama, H., Kanemoto, N., Minoda, Y. et al. Comparison of postoperative knee flexion and patient satisfaction between newly and conventionally designed medial pivot total knee arthroplasty: a 5-year follow-up matched cohort study. Arch Orthop Trauma Surg 142, 2057–2064 (2022). https://doi.org/10.1007/s00402-021-04121-6

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