Is a Titanium Implant for Total Knee Arthroplasty Better? A Randomized Controlled Study

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Medical Engineering

Background:

• Titanium (Ti) implants offer potential advantages in weight and modulus compared to cobalt-chrome (CoCr) implants for total knee arthroplasty (TKA).
• Investigating the clinical and radiologic outcomes of Ti vs. CoCr implants in TKA is crucial for optimizing patient care.

Purpose of the Study:

• To compare the clinical and radiologic outcomes of titanium (Ti) rotating-platform implants versus cobalt-chrome (CoCr) rotating-platform implants in patients undergoing bilateral primary total knee arthroplasty (TKA).

Main Methods:

• A randomized controlled trial involving 108 patients (216 knees) who received both Ti and CoCr implants in contralateral knees.
• Follow-up averaged 5.3 years, with evaluations including clinical scores, patient preferences, gait analysis, range of motion, pain levels, and radiographic assessment for radiolucent lines, bone loss, and loosening.

Main Results:

• No significant differences were found in clinical scores, patient-reported preferences (e.g., lightness), gait analysis, range of motion, or pain.
• Approximately 70% of patients did not perceive a difference in weight between the Ti and CoCr implants.
• The incidence of radiolucent lines (RLL) was lower in the Ti implant group (9%) compared to the CoCr implant group (19%).

Conclusions:

• Lighter weight titanium (Ti) implants did not provide superior clinical benefits over cobalt-chrome (CoCr) implants in total knee arthroplasty (TKA).
• The perceived lightness of Ti implants was not significant enough to influence patient preference or clinical outcomes.
• Titanium (Ti) implants demonstrated a reduced rate of radiolucent lines (RLL), suggesting a potential advantage in long-term radiographic performance.