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Related Concept Videos

Knee Joint01:23

Knee Joint

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The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...
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Related Experiment Video

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In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
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Benchmarking THA Implant Combinations Using Data From a US Total Joint Replacement Registry.

Tanmaya D Sambare1, Sung Jun Son1, Hong Sun2

  • 1Department of Orthopaedic Surgery, Los Angeles County-Harbor-UCLA Medical Center, Los Angeles, CA, USA.

Clinical Orthopaedics and Related Research
|December 29, 2025
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This study evaluated total hip arthroplasty (THA) implants using International Society of Arthroplasty Registries benchmarking. Most THA constructs met early benchmarks, but some consistently failed to meet standards, highlighting the need for scrutiny and registry incorporation.

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Health services research

Background:

  • Benchmarking is a surveillance method to assess implant performance against set standards.
  • Successful benchmarking indicates acceptable revision-free survivorship.
  • This evaluation provides insights for surgeons, industry, and regulatory bodies.

Purpose of the Study:

  • Apply International Society of Arthroplasty Registries (ISAR) benchmarking standards to a US total joint replacement registry.
  • Identify total hip arthroplasty (THA) implant constructs meeting benchmarks at 2, 5, 10, and 15 years.
  • Evaluate benchmark consistency across gender and age demographics.

Main Methods:

  • Utilized a US-based total joint replacement registry for a cohort study of 155,123 primary THAs (2001-2024).
  • Employed Kaplan-Meier estimates to calculate cumulative percent revision (CPR) and 95% confidence intervals (CIs).
  • Compared implant performance against ISAR benchmarking standards at 2, 5, 10, and 15 years, considering superiority and noninferiority.

Main Results:

  • 86% of THA constructs met the 2-year benchmark (≤2% revision rate); 90% met the 5-year benchmark (≤3% revision rate).
  • At 10 years, 13 constructs achieved superior benchmarks (≤5% revision rate) and 5 achieved noninferiority (≤6% revision rate).
  • Seven of eight constructs met the 15-year superior benchmark (≤6.5% revision rate); specific Zimmer-Biomet constructs consistently failed to meet benchmarks.

Conclusions:

  • The ISAR benchmarking methodology successfully identified superior, adequate, and underperforming THA implant combinations in a US registry.
  • Findings should inform implant selection for primary THA, with underperforming implants requiring scrutiny.
  • Incorporating this benchmarking methodology into US registries is recommended for improved implant surveillance.