[Clinical results and economics of two primary total knee replacement systems implanted in standardised surgical...

To evaluate the differences in clinical outcome and economics of primary total knee replacements, the results with two implant types (cruciate retaining and sacrificing) were analysed.

From 1/2000 until 6/2001 twenty-two consecutive patients with primary arthrosis of the knee underwent total knee replacement with the cruciate-retaining CKS-CC knee system (= group 1: 9 men, 13 women, mean age 65.68 years). Between 8/2001 and 3/2002 twenty-two consecutive patients received the cruciate-sacrificing NexGen Full Flex implant (= group 2: 4 men, 18 women, mean age 67.18 years). The operative procedures and rehabilitation regimes were standardised. The modified Insall score, patient satisfaction, as well as implant and rehabilitation costs were evaluated. Statistical analyses were based on two theses. I) There is no difference between the clinical early and five-year results of both groups. II) The more expensive NexGen implant is less economic regarding total costs per patient.

The more expensive, cruciate-sacrificing NexGen implant showed significantly better clinical results (p = 0.0005) and higher patient satisfaction while rehabilitation costs were lower (p = 0.003). While the clinical results remained unchanged, the revision rate after 5 years for the NexGen System was lower.

Not only minimally invasive surgery, but also choosing the right type of implant may lead to better early as well as mid-term clinical results in primary total knee arthroplasty. This may also reduce total costs per patient in primary total knee arthroplasty.