Early Outcomes of an Alternative Bearing Surface in Primary Total Knee Arthroplasty in Patients with Self-reported Metal Allergy
Background: Most implants for total knee arthroplasty (TKA) are comprised of alloys that contain nickel. Controversy exists whether metal allergies produce negative effects and affect clinical outcomes. The purpose of this study was to retrospectively review a minimum 2-year follow-up with an ion-bo...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-12-01
|
| Series: | Arthroplasty Today |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344120301400 |
| _version_ | 1818509963241193472 |
|---|---|
| author | Jesua I. Law, DO Micael J. Morris, MD Jason M. Hurst, MD Keith R. Berend, MD Adolph V. Lombardi, Jr., MD, FACS David A. Crawford, MD |
| author_facet | Jesua I. Law, DO Micael J. Morris, MD Jason M. Hurst, MD Keith R. Berend, MD Adolph V. Lombardi, Jr., MD, FACS David A. Crawford, MD |
| author_sort | Jesua I. Law, DO |
| collection | DOAJ |
| description | Background: Most implants for total knee arthroplasty (TKA) are comprised of alloys that contain nickel. Controversy exists whether metal allergies produce negative effects and affect clinical outcomes. The purpose of this study was to retrospectively review a minimum 2-year follow-up with an ion-bombarded titanium TKA implant in patients with reported metal sensitivity. Methods: A retrospective review of patients who underwent primary TKA with the ion-bombarded titanium Vanguard (Zimmer Biomet, Warsaw, IN) implant with 2-year minimum follow-up was performed from 2008 through 2017. The query revealed 346 patients (451 knees) with minimum 2-year follow-up. The mean age was 64.7 years, the mean body mass index was 35.1 kg/m2, and 95% of patients were women. Results: The mean follow-up was 4.6 years. The mean range of motion improved from 109° to 112° (P = .03), University of California Los Angeles activity scale from 4.1 to 5.1 (P < .001), Knee Society Clinical scores from 36 to 89 (P < .001), and Knee Society Functional scores from 48 to 73 (P < .001). There were 5 (1.1%) revisions: 2 infections (2-staged exchange), 1 tibial revision for aseptic loosening after a fall, and 2 bearing exchanges for instability. Other surgeries were open reduction internal fixation of periprosthetic fracture, 1 arthroscopic release of snapping popliteus, and 4 local wound incision and debridement (2 superficial infections and 2 nonhealing wounds). Manipulation under anesthesia was required in 27 (6%) patients. Conclusions: These early results are encouraging for the use of alternative metal titanium alloy implants in metal-sensitive patients undergoing primary TKA. At 4.6 years of mean follow-up, patients had substantial improvement in the range of motion and clinical outcomes with a low frequency of revision. |
| first_indexed | 2024-12-10T22:52:40Z |
| format | Article |
| id | doaj.art-7d9fd567809e426e85ee63a371c67a43 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-12-10T22:52:40Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-7d9fd567809e426e85ee63a371c67a432022-12-22T01:30:22ZengElsevierArthroplasty Today2352-34412020-12-0164639643Early Outcomes of an Alternative Bearing Surface in Primary Total Knee Arthroplasty in Patients with Self-reported Metal AllergyJesua I. Law, DO0Micael J. Morris, MD1Jason M. Hurst, MD2Keith R. Berend, MD3Adolph V. Lombardi, Jr., MD, FACS4David A. Crawford, MD5Joint Implant Surgeons, Inc., New Albany, OH, USA; Mount Carmel Health System, New Albany, OH, USAJoint Implant Surgeons, Inc., New Albany, OH, USA; Mount Carmel Health System, New Albany, OH, USAJoint Implant Surgeons, Inc., New Albany, OH, USA; Mount Carmel Health System, New Albany, OH, USAJoint Implant Surgeons, Inc., New Albany, OH, USA; Mount Carmel Health System, New Albany, OH, USAJoint Implant Surgeons, Inc., New Albany, OH, USA; Mount Carmel Health System, New Albany, OH, USA; Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USAJoint Implant Surgeons, Inc., New Albany, OH, USA; Corresponding author. Joint Implant Surgeons, Inc., 7277 Smith’s Mill Road, Suite 200, New Albany, OH 43054, USA. Tel.: +1 614 221 6331.Background: Most implants for total knee arthroplasty (TKA) are comprised of alloys that contain nickel. Controversy exists whether metal allergies produce negative effects and affect clinical outcomes. The purpose of this study was to retrospectively review a minimum 2-year follow-up with an ion-bombarded titanium TKA implant in patients with reported metal sensitivity. Methods: A retrospective review of patients who underwent primary TKA with the ion-bombarded titanium Vanguard (Zimmer Biomet, Warsaw, IN) implant with 2-year minimum follow-up was performed from 2008 through 2017. The query revealed 346 patients (451 knees) with minimum 2-year follow-up. The mean age was 64.7 years, the mean body mass index was 35.1 kg/m2, and 95% of patients were women. Results: The mean follow-up was 4.6 years. The mean range of motion improved from 109° to 112° (P = .03), University of California Los Angeles activity scale from 4.1 to 5.1 (P < .001), Knee Society Clinical scores from 36 to 89 (P < .001), and Knee Society Functional scores from 48 to 73 (P < .001). There were 5 (1.1%) revisions: 2 infections (2-staged exchange), 1 tibial revision for aseptic loosening after a fall, and 2 bearing exchanges for instability. Other surgeries were open reduction internal fixation of periprosthetic fracture, 1 arthroscopic release of snapping popliteus, and 4 local wound incision and debridement (2 superficial infections and 2 nonhealing wounds). Manipulation under anesthesia was required in 27 (6%) patients. Conclusions: These early results are encouraging for the use of alternative metal titanium alloy implants in metal-sensitive patients undergoing primary TKA. At 4.6 years of mean follow-up, patients had substantial improvement in the range of motion and clinical outcomes with a low frequency of revision.http://www.sciencedirect.com/science/article/pii/S2352344120301400Total knee arthroplastyMetal allergyTitaniumNickel |
| spellingShingle | Jesua I. Law, DO Micael J. Morris, MD Jason M. Hurst, MD Keith R. Berend, MD Adolph V. Lombardi, Jr., MD, FACS David A. Crawford, MD Early Outcomes of an Alternative Bearing Surface in Primary Total Knee Arthroplasty in Patients with Self-reported Metal Allergy Arthroplasty Today Total knee arthroplasty Metal allergy Titanium Nickel |
| title | Early Outcomes of an Alternative Bearing Surface in Primary Total Knee Arthroplasty in Patients with Self-reported Metal Allergy |
| title_full | Early Outcomes of an Alternative Bearing Surface in Primary Total Knee Arthroplasty in Patients with Self-reported Metal Allergy |
| title_fullStr | Early Outcomes of an Alternative Bearing Surface in Primary Total Knee Arthroplasty in Patients with Self-reported Metal Allergy |
| title_full_unstemmed | Early Outcomes of an Alternative Bearing Surface in Primary Total Knee Arthroplasty in Patients with Self-reported Metal Allergy |
| title_short | Early Outcomes of an Alternative Bearing Surface in Primary Total Knee Arthroplasty in Patients with Self-reported Metal Allergy |
| title_sort | early outcomes of an alternative bearing surface in primary total knee arthroplasty in patients with self reported metal allergy |
| topic | Total knee arthroplasty Metal allergy Titanium Nickel |
| url | http://www.sciencedirect.com/science/article/pii/S2352344120301400 |
| work_keys_str_mv | AT jesuailawdo earlyoutcomesofanalternativebearingsurfaceinprimarytotalkneearthroplastyinpatientswithselfreportedmetalallergy AT micaeljmorrismd earlyoutcomesofanalternativebearingsurfaceinprimarytotalkneearthroplastyinpatientswithselfreportedmetalallergy AT jasonmhurstmd earlyoutcomesofanalternativebearingsurfaceinprimarytotalkneearthroplastyinpatientswithselfreportedmetalallergy AT keithrberendmd earlyoutcomesofanalternativebearingsurfaceinprimarytotalkneearthroplastyinpatientswithselfreportedmetalallergy AT adolphvlombardijrmdfacs earlyoutcomesofanalternativebearingsurfaceinprimarytotalkneearthroplastyinpatientswithselfreportedmetalallergy AT davidacrawfordmd earlyoutcomesofanalternativebearingsurfaceinprimarytotalkneearthroplastyinpatientswithselfreportedmetalallergy |