A mid-term clinical outcome study of the Advance Medial Pivot knee arthroplasty

• Published in: The knee 2009-12, Vol.16 (6), p.484-488
• Main Authors: Karachalios, Theofilos, Roidis, Nikolaos, Giotikas, Dimitrios, Bargiotas, Konstantinos, Varitimidis, Socrates, Malizos, Konstantinos N
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arthritis; Arthroplasty, Replacement, Knee - instrumentation; Arthroplasty, Replacement, Knee - rehabilitation; Clinical outcome study; Clinical outcomes; Confidence intervals; Design; Equipment Design; Female; Follow-Up Studies; Humans; Joint surgery; Kaplan-Meier Estimate; Knee; Knee kinematics; Knee Prosthesis; Male; Medial pivot knee design; Middle Aged; Molecular weight; Orthopedics; Pain Measurement; Prospective Studies; Prostheses; Range of Motion, Articular; Recovery of Function; Surgery; Total Knee Arthroplasty; Wound healing
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2009.03.002

Abstract The Advance Medial Pivot Total Knee Arthroplasty (Wright Medical Technology, Arlington, Tennessee, USA) has been designed to reproduce modern ideas of knee kinematics. We report a prospective clinical outcome study of 284 arthroplasties in 225 consecutive patients with a mean follow-up of 6.7 years (range 4 to 9 years). For evaluation, both objective and subjective clinical rating systems and serial radiographs were used. At final follow-up, 10 (4.4%) patients (10 knees) only were lost from follow-up and four (1.8%) patients (five knees) had died for reasons unrelated to the surgery with their knees performing well. There was an 82% compliance in the intervals of follow-up evaluation. All patients showed a statistically significant improvement ( p = 0.01) in the Knee Society clinical rating system, WOMAC questionnaire, SF-12 questionnaire, and Oxford knee score. The majority of patients (92%) were able to perform age-appropriate activities with a mean knee flexion of 117° (range 85° to 135°) at final follow-up. Survival analysis showed a cumulative success rate of 99.1% at 5 years. Two (0.7%) arthoplasties, in which patient selection and surgical errors were identified, were revised due to aseptic loosening, one due to infection and one due to a traumatic dislocation. This study demonstrates satisfactory mid-term clinical results for this knee design.