A Randomized Controlled Trial Comparing a Medial Stabilised Total Knee Prosthesis to a Cruciate Retaining and Posterior Stabilised Design - A Report of the Clinical and Functional Outcomes Following Total Knee Replacement
AuthorDowsey, MM; Gould, D; Spelman, T; Pandy, MG; Choong, PF
Source TitleJournal of Arthroplasty
University of Melbourne Author/sDowsey, Michelle; Gould, Daniel; Choong, Peter; Pandy, Marcus; Spelman, Timothy
Surgery (St Vincent's)
Document TypeJournal Article
CitationsDowsey, M. M., Gould, D., Spelman, T., Pandy, M. G. & Choong, P. F. (2020). A Randomized Controlled Trial Comparing a Medial Stabilised Total Knee Prosthesis to a Cruciate Retaining and Posterior Stabilised Design - A Report of the Clinical and Functional Outcomes Following Total Knee Replacement. The Journal of Arthroplasty, 35 (6), pp.1583-1590. https://doi.org/10.1016/j.arth.2020.01.085.
Access StatusOpen Access
Background The purpose of this randomized controlled trial was to compare the performance of 3 total knee joint replacement (TKJR) designs 6 months after the surgery. Methods Patients were recruited between March 2015 and March 2018. Patients with osteoarthritis consented for TKJR were randomly allocated to a medial stabilized (MS), cruciate retaining (CR), or posterior stabilized (PS) design. Primary outcome measures were self-reported improvement in pain and function 6 months after TKJR, using the Oxford Knee Score. Secondary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index, Veterans RAND 12-item Health Survey, Knee Society Score 2011, Timed Up and Go test, and Six-Minute Walk Test. Twelve-month outcomes were also measured. Results Ninety participants enrolled, 83 were randomized: PS (n = 26), CR (n = 28), and MS (n = 29) designs. One case withdrew before surgery: planned use of non-study implant; 7 did not complete all outcome measures. No 6-month between-group difference was observed for the primary outcome. A 6-month difference was observed in Knee Society Score 2011 Satisfaction: MS favored over CR and PS. Clinically meaningful 12-month differences in Western Ontario and McMaster Universities Osteoarthritis Index Pain, Function, and Global Subscales were observed: MS favored over CR. Twelve-month differences occurred in Veterans RAND 12-item Health Survey mental well-being, favoring MS and PS over CR. Conclusion MS prosthesis can be expected to yield similar clinical and functional outcomes to PS and CR designs 6 months after TKJR, and patients were more satisfied with their outcome. Compared with CR, patients with MS prosthesis also reported superior pain, function, and quality-of-life outcomes at 12 months.
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