Mid-term survivorship of primary total knee arthroplasty with a specific implant: high rate of aseptic failure. (1st March 2023)

• Record Type: Journal Article
• Authors: Gausden, Elizabeth B.; Puri, Simarjeet; Chiu, Yu-fen; Figgie, Mark P.; Sculco, Thomas P.; Westrich, Geoffrey; Sculco, Peter K.; Chalmers, Brian P.
• Is Part Of: Bone & joint journal. Volume 105:Number 3(2023)
• Page Start: 277
• Page End: 283
• Publication Date: 2023-03-01
• Subjects: Bones -- Surgery -- Periodicals; Joints -- Surgery -- Periodicals; Orthopedic surgery -- Periodicals; 617.47005
• DOI: 10.1302/0301-620X.105B3.BJJ-2022-0616.R1
• Languages: English
• ISSNs: 2049-4394

Abstract

Abstract : Aims: The purpose of this study was to assess mid-term survivorship following primary total knee arthroplasty (TKA) with Optetrak Logic components and identify the most common revision indications at a single institution. Methods: We identified a retrospective cohort of 7, 941 Optetrak primary TKAs performed from January 2010 to December 2018. We reviewed the intraoperative findings of 369 TKAs that required revision TKA from January 2010 to December 2021 and the details of the revision implants used. Kaplan-Meier analysis was used to determine survivorship. Cox regression analysis was used to examine the impact of patient variables and year of implantation on survival time. Results: The estimated survivorship free of all-cause revision was 98% (95% confidence interval (CI) 97% to 98%), 95% (95% CI 95% to 96%), and 86% (95% CI 83% to 88%) at two, five, and ten years, respectively. In 209/369 revisions there was a consistent constellation of findings with varying severity that included polyethylene wear and associated synovitis, osteolysis, and component loosening. This failure mode, which we refer to as aseptic mechanical failure, was the most common revision indication. The mean time from primary TKA to revision for aseptic mechanical failure was five years (5 months to 11 years). Conclusion: In this series of nearly 8, 000 primary TKAs performed with a specific implant, we identified a lower-than-expected mid-term survivorship and a high number of revisions with a unique presentation. This study, along with the recent recall of the implant, confirms the need for frequent monitoring of patients with Optetrak TKAs given the incidence of polyethylene failure, osteolysis, and component loosening. Cite this article: Bone Joint J 2023;105-B(3):277–283.