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Patient-Reported Outcomes following Single- and Multiple-Radius Total Knee Replacement: A Randomized, Controlled
Nadeem Mushtaq1, Alexander D Liddle2, David Isaac3
1Department of Trauma and Orthopaedic Surgery, Imperial College Healthcare NHS Trust, London, United Kingdom.
The Journal of Knee Surgery
|May 6, 2017
Summary
Single-radius (SR) total knee replacement (TKR) showed no short-term functional advantage over multiple-radius (MR) designs. This randomized controlled study found similar patient-reported outcomes, suggesting SR benefits are not clinically significant initially.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Clinical Trials
Background:
- Single-radius (SR) total knee replacement (TKR) designs theoretically offer advantages over traditional multiple-radius (MR) designs.
- However, the clinical superiority of SR TKR designs remains unproven in comparative studies.
- This research addresses the lack of evidence regarding the short-term clinical benefits of SR TKR.
Purpose of the Study:
- To compare the short-term clinical outcomes of single-radius (SR) versus multiple-radius (MR) total knee replacement (TKR) designs.
- To evaluate patient-reported outcomes using the Oxford Knee Score (OKS) and Knee Society Score (KSS).
- To determine if theoretical benefits of SR TKR translate into demonstrable functional advantages.
Main Methods:
- A randomized controlled trial involving 105 knees undergoing TKR.
- Patients were randomized to receive either a single-radius (Scorpio, Stryker) or multiple-radius (AGC, Zimmer Biomet) TKR.
- Patient-reported outcomes (OKS and KSS) were collected at 6 weeks, 6 months, and 1 year post-surgery.
Main Results:
- No significant differences were observed in primary outcomes between SR and MR TKR groups.
- Oxford Knee Score (OKS) at 1 year: SR group (39.5) vs. MR group (38.1) (p=0.40).
- Knee Society Score (KSS) at 1 year: SR group (168.4) vs. MR group (159.5) (p=0.16).
- A statistically significant, though clinically uncertain, improvement in the KSS objective subscale favored the SR design (p=0.04).
- No revisions were required in either group.
Conclusions:
- The theoretical benefits of single-radius (SR) total knee replacement designs do not confer demonstrable functional advantages in the short term.
- Patient-reported outcomes and overall function were comparable between SR and MR TKR designs within the first year.
- Further long-term studies may be needed to ascertain any potential differences in clinical outcomes.
