Patient-reported outcomes and complications of a new-generation total knee system: a randomized controlled trial

新一代全膝关节置换系统的患者报告结局和并发症:一项随机对照试验

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Abstract

BACKGROUND AND PURPOSE: Documentation of new-generation implants' short-term performance could reassure surgeons and patients about their use, while awaiting the long-term outcome. Our aim was to compare the performance of a newer total knee arthroplasty (TKA) system with its predecessor, measured by patient-reported knee function, pain, and complication rate. METHODS: We performed a multi-center, randomized, controlled trial (clinicaltrials.gov ID: NCT03073941). 314 patients with primary osteoarthritis were randomized to treatment with a Persona or NexGen cruciate-retaining TKA system and followed for 2 years. The primary outcome was measured with the patient-reported outcome (PRO) Oxford Knee Score (OKS) 2 years post-surgery. Secondary outcomes were the OKS-Activity and Participation questionnaire (OKS-APQ), Forgotten Joint Score (FJS), EQ-5D-3L, and number of complications during the study period. Responder analyses were performed using Patient Acceptable Symptom State (PASS) and Minimal Important Change (MIC) criteria. RESULTS: Primary outcome was available from 289 patients (92%). We found no difference in adjusted mean OKS between the groups 2 years post-surgery (0.1, 95% confidence interval -1.4 to 1.7). We found no significant differences in adjusted mean of secondary PROs, PRO time-weighted averages, proportion of patients with PASS or MIC, or complications 2 years post-surgery. CONCLUSION: We found no difference in OKS 2 years post-surgery, or in any secondary variables analyzed including complications, between the 2 TKA systems. Short-term safety and performance of the Persona TKA was comparable to its predecessor.

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