Mats Molt1, Andreas Harsten2, Sören Toksvig-Larsen3. 1. Department of Orthopaedics, Hässleholm-Kristianstad-Ystad, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden. Electronic address: mats.molt@skane.se. 2. Department of Anaesthesiology, Hässleholm Hospital, Hässleholm, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden. 3. Department of Orthopaedics, Hässleholm-Kristianstad-Ystad, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden.
Abstract
BACKGROUND: A concern that arises with any change in technique is whether it affects the long-term implant stability. The objective of this study was to evaluate the early migration, measured by radiostereometric analysis (RSA), and the functional outcome of the Triathlon™ cemented knee prosthesis, operated on with or without a tourniquet. During the last decades RSA has emerged as a way to assess prosthetic fixation and long time prognosis. The method has been used extensively in both hip and knee arthroplasty. METHOD: This was a single centre prospective study including 60 patients randomized into two groups operated on either with or without tourniquet. RSA investigation was done within 2-3 days postoperatively after full weight bearing, and then at 3 months, 1 year and 2 years postoperatively. RESULTS: There were no differences between the groups regarding the translation along or rotation around the three coordinal axes, or in maximum total point motion (MTPM). At 2 years the mean MTPM (SD) was 0.71 mm (0.64) for the tourniquet-group and 0.53 mm (0.21) for the non-tourniquet-group. CONCLUSIONS: The tibial tray of the Triathlon™ cemented knee prosthesis showed similar early stability whether operated on with or without tourniquet. LEVEL OF EVIDENCE: Level I. ARTICLE SUMMARY: Article focus: A safety study for total knee replacement operated on with or without perioperative tourniquet regarding the prosthetic fixation. Strengths and limitations: Strength of this study is that it is a randomized prospective trial using an objective measuring tool. The sample size of 25-30 patients is reportedly sufficient for the screening of implants using RSA (1-3). TRIAL REGISTRATION: Clinical trials NCT01604382, Ethics Committee approval D-nr: 144/20085.
RCT Entities:
BACKGROUND: A concern that arises with any change in technique is whether it affects the long-term implant stability. The objective of this study was to evaluate the early migration, measured by radiostereometric analysis (RSA), and the functional outcome of the Triathlon™ cemented knee prosthesis, operated on with or without a tourniquet. During the last decades RSA has emerged as a way to assess prosthetic fixation and long time prognosis. The method has been used extensively in both hip and knee arthroplasty. METHOD: This was a single centre prospective study including 60 patients randomized into two groups operated on either with or without tourniquet. RSA investigation was done within 2-3 days postoperatively after full weight bearing, and then at 3 months, 1 year and 2 years postoperatively. RESULTS: There were no differences between the groups regarding the translation along or rotation around the three coordinal axes, or in maximum total point motion (MTPM). At 2 years the mean MTPM (SD) was 0.71 mm (0.64) for the tourniquet-group and 0.53 mm (0.21) for the non-tourniquet-group. CONCLUSIONS: The tibial tray of the Triathlon™ cemented knee prosthesis showed similar early stability whether operated on with or without tourniquet. LEVEL OF EVIDENCE: Level I. ARTICLE SUMMARY: Article focus: A safety study for total knee replacement operated on with or without perioperative tourniquet regarding the prosthetic fixation. Strengths and limitations: Strength of this study is that it is a randomized prospective trial using an objective measuring tool. The sample size of 25-30 patients is reportedly sufficient for the screening of implants using RSA (1-3). TRIAL REGISTRATION: Clinical trials NCT01604382, Ethics Committee approval D-nr: 144/20085.
Authors: Imran Ahmed; Amit Chawla; Martin Underwood; Andrew J Price; Andrew Metcalfe; Charles Hutchinson; Jane Warwick; Kate Seers; Helen Parsons; Peter Dh Wall Journal: Cochrane Database Syst Rev Date: 2020-12-08
Authors: Henrik Husted; Kirill Gromov; Henrik Malchau; Andrew Freiberg; Peter Gebuhr; Anders Troelsen Journal: Acta Orthop Date: 2014-10-06 Impact factor: 3.717