Background
Methods
SR group | MR group | P value | |
---|---|---|---|
Patients | 106 | 114 | – |
Gender (female/male) | 82/24 | 78/36 | 0.1369 |
Age | 69.54 ± 10.57 | 68.98 ± 10.23 | 0.8418 |
BMI | 23.38 ± 2.58 | 23.45 ± 2.61 | 0.6901 |
Follow-up years | 10.72 ± 1.78 | 10.65 ± 1.87 | – |
Diagnoses | |||
Primary osteoarthritis | 81 (76.74%) | 85 (78.31%) | 0.7496 |
Rheumatic arthritis | 20 (17.44%) | 23 (15.66%) | 0.8069 |
Posttraumatic arthritis | 2 (2.33%) | 2 (2.41%) | 0.3769 |
Gouty arthritis | 3 (3.49%) | 4 (3.61%) | 0.2864 |
Surgical technique
Evaluation
Statistical analysis
Results
Clinical and functional results
Reason for drop out | SR group | MR group | Total |
---|---|---|---|
Withdrew (not contactable) | 12 | 14 | 26 |
Revised | 4 | 5 | 9 |
Death | 3 | 4 | 7 |
Total | 19 | 23 | 42 |
SR (n = 106) | MR (n = 114) | P value | |
---|---|---|---|
Functional results | |||
HSS | |||
Preoperative | 41.23 ± 5.76 | 42.35 ± 5.34 | 0.1359 |
Final follow-up | 86.32 ± 10.22 | 84.52 ± 10.53 | 0.2002 |
KSS (knee) | |||
Preoperative | 40.56 ± 15.62 | 42.63 ± 17.36 | 0.5700 |
Final follow-up | 84.52 ± 18.50 | 85.63 ± 16.82 | 0.6416 |
KSS (function) | |||
Preoperative | 45.62 ± 16.57 | 44.58 ± 17.56 | 0.6517 |
Final follow-up | 86.23 ± 17.50 | 85.14 ± 16.20 | 0.6319 |
WOMAC score | |||
Preoperative | 54.68 ± 18.69 | 56.23 ± 17.52 | 0.5261 |
Final follow-up | 21.83 ± 15.60 | 23.24 ± 15.80 | 0.5064 |
SF-12 | |||
Preoperative | 28.84 ± 6.45 | 30.13 ± 6.14 | 0.1300 |
Final follow-up | 52.48 ± 5.34 | 51.21 ± 5.35 | 0.1394 |
ROM (flexion) | |||
Preoperative | 105.52 ± 10.78° | 104.18 ± 10.62° | 0.3542 |
Final follow-up | 115.65 ± 10.32° | 115.50 ± 10.13° | 0.9135 |
ROM (extension) | |||
Preoperative | 10.23 ± 2.45° | 10.34 ± 2.23° | 0.7277 |
Final follow-up | 3.42 ± 1.22° | 3.28 ± 1.25° | 0.4020 |
Chair test (complete) | 88 (83.02%) | 93 (81.58%) | 0.7799 |
Pain | |||
VAS | |||
Preoperative | 6.45 ± 1.25 | 6.57 ± 1.38 | 0.5009 |
Final follow-up | 0.42 ± 0.15 | 0.44 ± 0.12 | 0.2744 |
Anterior knee pain | 9 (10.38%) | 20 (17.54%) | 0.0251* |
Painless crepitation | 17 (16.34%) | 26 (28.07%) | 0.0383* |
Painful crepitation | 2 (1.89%) | 3 (2.63%) | 0.3287 |
Component evaluation | |||
Radiological line | |||
< 2 mm | 8 (7.69%) | 10 (8.77%) | 0.1842 |
> 2 mm | 0 (0%) | 0 (0%) | – |
LDFA (α) ° | 84.32 ± 3.15 | 84.57 ± 3.25 | 0.5635 |
MDTA (β) ° | 89.87 ± 3.24 | 89.56 ± 3.32 | 0.4846 |
FEFA (γ) ° | 6.54 ± 1.68 | 6.76 ± 2.26 | 0.4162 |
TSA(σ) ° | 88.25 ± 3.53 | 87.82 ± 3.72 | 0.3809 |
Pain and crepitation
Radiological results
Satisfaction rate
SR (n = 106) | MR (n = 114) | Total | |
---|---|---|---|
Very satisfied | 76 | 74 | 150 |
Satisfied | 23 | 31 | 54 |
Uncertain | 5 | 7 | 12 |
Unsatisfied | 2 | 2 | 4 |
Total | 106 | 114 | 220 |
Complication and survivorship
Discussion
First author | Year | Design | Origin | Minimal follow-up (M) | Participants | Prostheses | Postoperative results | Complication (required revision) | Survival | Conclusion | |||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
SR | MR | SR | MR | P value | |||||||||
Molt | 2012 | PRCT | Sweden | 24 | 25 | 25 | SR: Stryker Triathlon, CR MR: Stryker Duracon, CR | KSS knee, 61.84 ± 2.62 KSS function, 86.94 ± 6.33 Mean RSA, 0.76 ± 0.18 | KSS knee, 63.84 ± 3.67 KSS function, 88.96 ± 6.33 Mean RSA, 0.63 ± 0.26 | > 0.05 > 0.05 0.462 | N/A | SR, 100% MR, 100% | SR has similar early stability and same function to MR |
Jo | 2014 | PRCT | South Korea | 24 | 50 | 50 | SR: Stryker Scorpio NRG, CR MR: Zimmer NexGen, CR | HSS, 90.1 ± 6.2 WOMAC, 21.9 ± 8.2 ROM, 128.7 ± 11.6 Stability stress at 30°, 7.6 | HSS, 91.9 ± 7.0 WOMAC, 20.2 ± 12.9 ROM, 126.0 ± 12.7 Stability stress at 30°, 8.3 | 0.42 0.13 0.26 < 0.01 | N/A | SR, 100% MR, 100% | SR better intra-operative stability at 30° of flexion. Clinical results no differences in two groups |
Palmer | 2014 | RCS | Australia | 24 | 338 | 674 | SR: Stryker Scorpio NRG, CR MR: Stryker Duracon, CR | KSS knee, 89.5 ± 10.3 KSS function, 71.7 ± 21.5 ROM, 108.5 ± 12.5 No pain, 66.3% | KSS knee, 83.5 ± 14.8 KSS function, 68.7 ± 23.0 ROM, 106.5 ± 13.7 No pain, 54.4% | < 0.05 0.046 0.02 < 0.05 | N/A | SR, 100% MR, 100% | SR better knee flexion, knee score and function score than MR |
Hamilton | 2015 | PRCT | UK | 36 | 90 | 75 | SR: Stryker Triathlon, CR MR: Stryker Kinemax, CR | OKS (change), 17.1 (− 14 to 33) ROM, 108.5 ± 9.7 Lower limb power, (94 ± 34)% Worst daily pain, 1.7 ± 1.5 Average pain, 0.5 ± 1.2 | OKS (change), 20.1(−3 to 39) ROM, 99.8 ± 9.7 Lower limb power, (116 ± 40)% Worst daily pain, 2.5 ± 2.2 Average pain, 0.9 ± 1.4 | 0.05 < 0.05 < 0.05 < 0.05 0.57 | SR: 1 early infection MR: 2 early infection, 1 revised | N/A | SR better function (lower limb power and knee flexion), pain levels, and overall satisfaction |
Oliviu | 2016 | RCS | Romania | 32 | 94 | 70 | SR: Stryker NRG, PS MR: Zimmer NexGen, PS | KSS knee, 87.2 ± 7.5 KSS function, 86.2 ± 7.1 | KSS knee, 86.8 ± 11.3 KSS function, 81.5 ± 13.7 | > 0.05 > 0.05 | SR: 1 apparent and 1 impending mechanical failure MR: 1 impending mechanical failure | SR, 95.8% (95% CI 91.8–99.8%) MR, 92.7% (95% CI 87.7–97.7%) (at 60 months, P = 0.31) | No differences in two groups. |
Isabel | 2017 | PRCT | Spain | 60 | 118 | 119 | SR: Italy Samo, CR MR: Italy Lima, CR | KSS knee, 83.9 ± 6.6 KSS function, 84.2 ± 8.5 ROM, 105.2 ± 10.0 Quadriceps strength, 3.0 ± 1.2 Chair test, 103/15 | KSS knee, 83.9 ± 6.6 KSS function, 84.2 ± 8.5 ROM, 99.4 ± 8.1 Quadriceps strength, 2.6 ± 0.9 Chair test, 92/27 | 0.001 0.001 0.001 0.004 0.032 | SR: 1 deep wound infection, 2 aseptic tibial loosening MR: 1 deep wound infection, 2 aseptic tibial loosening; 1 periprosthetic femoral fracture | SR, 97.4% (95% CI 92.4–100%) MR, 97.4% (95% CI 94.6–100%) (at 60 months, P > 0.05) | SR shows better results than MR. The use of SR system is recommended |
This study | 2018 | RCS | China | 120 | 106 | 114 | SR: Stryker NRG, PS MR: Sigma PFC, PS | HSS, 86.32 ± 10.22 KSS knee, 84.52 ± 18.50 KSS function, 86.23 ± 17.50 WOMAC, 21.83 ± 15.60 ROM, 115.65 ± 10.32° Anterior knee pain, 9 (10.38%) Chair test, 88 (83.02%) | HSS, 84.52 ± 10.53 KSS knee, 85.63 ± 16.82 KSS function, 85.14 ± 16.20 WOMAC, 23.24 ± 15.80 ROM, 115.50 ± 10.13° Anterior knee pain, 20 (17.54%) Chair test, 93 (81.58%) | 0.200 0.570 0.614 0.632 0.501 0.025 0.780 | SR: 1 periprosthetic fracture, 3 prosthesis loosening; MR: 2 periprosthetic fracture, 3 prosthesis loosening | SR, 94.4% (95% CI 90.4–98.4%) MR, 93.4% (95% CI 89.4–97.4%) (at 120 months, P = 0.7519) | SR less anterior knee pain than MR. Clinical, radiological, and survival results no differences in two groups. |