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10-Year Follow-Up for a New Three-Dimensional Printed Cementless Total Knee Arthroplasty
Nicolina R Zappley1, Santiago Restrepo1, Andrew Fraval1
1Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.
Background:
Cementless total knee arthroplasty (TKA) offers the potential for durable fixation through biological integration compared to cemented TKA, where fixation is achieved through mechanical interdigitation of the cement. To our knowledge, no 10-year results are available for newer cementless TKA designs that have incorporated additive manufacturing (three-dimensional [3D] printing). The purpose of this study was to present 10-year survivorship and clinical/radiographic outcomes of a newer cementless TKA design.
Methods:
This is a single institution registry review of prospectively obtained data from a total of 113 cementless TKAs at a 10-year follow-up. Outcomes were determined by comparing pre-and post-operative Knee Injury and Osteoarthritis Outcome Scores for Joint Replacement scores and pre- and post-operative 12-item Veterans RAND/Short Form Health Survey. Aseptic loosening as well as revision for any reason were the end points used to determine survivorship at 10 years.
Results:
The overall survivorship was 96.5% at 10 years, and survivorship for aseptic loosening as the end point was 98.2%, with a 99.1% survivorship of the 3D printed tibial component. There were four revisions performed (all within 2 years postoperatively) for an overall revision rate of 3.5%: two infections (1.7%) and two loosenings (1.7%). No new loosening was identified after 2 years of follow-up. At long-term 10-year follow-up, the mean Knee Injury and Osteoarthritis Outcome Scores for Joint Replacement score improved from 38.2 preoperatively to 72.8 postoperatively (P = 0.0001), the mean 12-item Veterans RAND/Short Form Health Survey scores improved from physical health-29.8 preoperatively to 40.6 postoperatively (P = 0.0001), and the mental health scores improved from 37.02 preoperatively to 54.3 postoperatively (P = 0.0001).
Conclusions:
This 3D printed cementless total knee system shows exceptional survivorship at a 10-year follow-up. The design of this implant and the ability to obtain cementless fixation offer promise for excellent long-term durability.
