A Prospective Randomized Study Comparing Postoperative Pain, Biological Fixation, and Clinical Outcomes Between Two...

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Implant technology

Background:

• Rising demand for arthroplasty necessitates improved prosthesis longevity.
• Biological fixation using cementless implants is a key strategy for enhancing implant lifespan.
• Hydroxyapatite (HA) coating and pegs are potential enhancements for porous-coated tibial trays.

Purpose of the Study:

• To evaluate if HA coating and pegs improve osseointegration and clinical outcomes in total knee arthroplasty.
• To assess the impact of HA and pegs on early postoperative pain and rehabilitation.
• To determine the effect of HA and pegs on the incidence of radiolucent lines (RLLs).

Main Methods:

• Prospective, randomized, single-blinded study comparing two cementless tibial tray designs.
• 197 patients (205 knees) underwent primary total knee arthroplasty.
• Follow-up extended to 10 years, assessing pain, radiographic fixation, and clinical outcomes.

Main Results:

• No significant differences in pain or patient-reported outcomes between the two implant designs.
• The tibial tray with HA and pegs showed significantly fewer RLLs at all follow-up points.
• No loosening or osteolysis observed; one revision for infection in the porous coating only group.

Conclusions:

• HA coating and pegs did not enhance early pain relief or patient outcomes.
• The enhanced tibial tray design significantly reduced RLLs.
• Cementless porous-coated tibial components may exhibit normal nonprogressive RLLs.